Individual
MARIA ISELA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10948 N MAY AVE STE B, OKLAHOMA CITY, OK 73120-6224
(405) 751-8966
Mailing address
7148 LYREWOOD LN, OKLAHOMA CITY, OK 73132-6380
(405) 619-8342
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200287120A
—
OK
Enumeration date
07/18/2012
Last updated
07/18/2012
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