Individual
TEALAI RAECHAL GONELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18330 N 79TH AVE APT 1048, GLENDALE, AZ 85308-8345
(602) 516-4188
Mailing address
18330 N 79TH AVE APT 1048, GLENDALE, AZ 85308-8345
(602) 516-4188
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
AZ
Other
Enumeration date
03/15/2007
Last updated
07/26/2007
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