Individual
DR. VICTOR GONZALEZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
3380 TRICKUM RD, BUILDING 1000, SUITE 102, WOODSTOCK, GA 30188-3680
(770) 924-9700
(770) 926-0690
Mailing address
4520 CLUB HOUSE DR, MARIETTA, GA 30066-2473
(404) 245-7143
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002448
GA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY002448
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000913646A
—
GA
Enumeration date
09/27/2007
Last updated
11/04/2011
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