Individual
HERMAN GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AAS
Contact information
Practice address
20 COMMUNITY LN, LIBERTY, NY 12754-2851
(845) 292-8770
(845) 292-4206
Mailing address
PO BOX 12, SWAN LAKE, NY 12783-0012
(845) 292-8770
(845) 292-4206
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/30/2007
Last updated
11/30/2007
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