Individual
JUAN GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DR.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY-T-000068
AZ
390200000X
Student in an Organized Health Care Education/Training Program
PSY-T-000068
AZ
Other
Enumeration date
01/20/2025
Last updated
06/16/2025
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