Individual
INGRID GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2780 W 63RD PL APT 104, HIALEAH, FL 33016-4358
(786) 569-2769
Mailing address
2780 W 63RD PL APT 104, HIALEAH, FL 33016-4358
(786) 569-2769
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
BCABA-0-21-13056
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112140300
—
FL
Enumeration date
01/07/2020
Last updated
03/04/2025
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