Individual
MR. MARK GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
3035 NW 63RD ST, 230, OKLAHOMA CITY, OK 73116-3632
(405) 242-5342
(405) 529-6972
Mailing address
3035 NW 63RD ST, 230, OKLAHOMA CITY, OK 73116-3632
(405) 242-5342
(405) 529-6972
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2458
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200305510A
—
OK
Enumeration date
03/13/2008
Last updated
03/26/2015
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