Individual
EVANGELINE GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7400 HANCOCK CT NE STE A, ALBUQUERQUE, NM 87109-4592
(505) 206-1109
Mailing address
PO BOX 44656, RIO RANCHO, NM 87174-4656
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-08897
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2287129
—
NM
Enumeration date
07/17/2015
Last updated
02/27/2019
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