Individual
MR. MANUEL GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
9330 S BROADWAY, CROOWN POINT, IN 46307
(219) 662-5082
Mailing address
7211 WICKER AVE, HAMMOND, IN 46323
(219) 989-8064
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34000399A
IN
Other
Enumeration date
09/22/2006
Last updated
07/08/2007
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