Individual
THAIS GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
416 GANTT DR, MARTINSBURG, WV 25403-0281
(240) 506-1217
Mailing address
416 GANTT DR, MARTINSBURG, WV 25403-0281
(240) 506-1217
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
52358
FL
Other
Enumeration date
12/04/2013
Last updated
12/04/2013
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