Individual
TALIA MARIE GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1240 RUDDELL RD SE, LACEY, WA 98503-5747
(360) 970-4778
Mailing address
727 DUNDEE RD NW, OLYMPIA, WA 98502-4428
(510) 333-1418
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
Primary
OT61190256
WA
Other
Enumeration date
03/15/2018
Last updated
08/04/2021
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