Individual
ANDREA GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6763 US 64, BLOOMFIELD, NM 87413-9564
(505) 716-7241
Mailing address
6763 US 64, BLOOMFIELD, NM 87413-9564
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/17/2020
Last updated
12/17/2020
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