Individual
CRISELDA GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 21ST AVE S STE 410, NASHVILLE, TN 37212-4929
(615) 569-1939
Mailing address
1391 FOXLAND BLVD APT J303, GALLATIN, TN 37066-4285
(615) 569-1939
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3397960
—
TN
Enumeration date
04/23/2012
Last updated
09/19/2018
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