Individual
MR. DERECK HUGH GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
34 S 300 E, PROVO, UT 84606-3201
(801) 850-9147
(435) 578-0700
Mailing address
34 S 300 E, PROVO, UT 84606-3201
(801) 850-9147
(435) 578-0700
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12883692-3502
UT
Other
Enumeration date
05/18/2021
Last updated
10/20/2022
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