Individual
TATIANA MICHELLE GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2836 KIMBERLIE CT, ANCHORAGE, AK 99508-5329
(907) 349-4222
Mailing address
5340 E 26TH AVE, ANCHORAGE, AK 99508-3851
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-45171
AK
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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