Individual
EUGENE GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 N 5TH AVE, HOLBROOK, AZ 86025-2817
(928) 524-6126
(928) 524-6090
Mailing address
PO BOX 972, HOLBROOK, AZ 86025-0972
(928) 524-2728
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-1244
AZ
174400000X
Specialist
256
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
167332
AHCCCS
AZ
Enumeration date
02/02/2007
Last updated
09/11/2025
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