Individual
LISA RENEE GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
2045 E WEST MAPLE RD STE D407, COMMERCE TOWNSHIP, MI 48390-3801
(248) 926-0909
(248) 624-3332
Mailing address
2045 E WEST MAPLE RD STE D407, COMMERCE TOWNSHIP, MI 48390-3801
(248) 926-0909
(248) 624-3332
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101006673
MI
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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