Individual
LICELOT GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
600 MEADOWLANDS PKWY, SUITE 142, SECAUCUS, NJ 07094-1633
(201) 446-7580
Mailing address
600 MEADOWLANDS PKWY, SUITE 142, SECAUCUS, NJ 07094-1633
(201) 446-7580
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/09/2015
Last updated
05/08/2016
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