Individual
DR. JARED GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1395 MISSOURI AVE, LAS CRUCES, NM 88001-5327
(575) 621-4304
Mailing address
4672 MESITA ST, LAS CRUCES, NM 88012-6329
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY1734
NM
103TS0200X
School Psychologist
313091
NM
Other
Enumeration date
10/18/2013
Last updated
10/13/2022
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