Individual
KAYLA GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 SOUTHERN BLVD, BRONX, NY 10455-4609
(347) 978-2079
Mailing address
501 SOUTHERN BLVD, BRONX, NY 10455-4609
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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