Individual
CARLY GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
141 OSUNA RD NW, ALBUQUERQUE, NM 87107-6041
(505) 225-5323
Mailing address
9123 PALOMAS AVE NE, ALBUQUERQUE, NM 87109-6632
(915) 999-1142
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-9486
—
Other
Enumeration date
12/07/2012
Last updated
10/06/2021
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