Individual
TIFFANI GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 PILLING ST, BROOKLYN, NY 11207-1610
(718) 602-1000
Mailing address
765 E 163RD ST APT 11C, BRONX, NY 10456-7223
(646) 761-4603
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
MI2851
NV
106H00000X
Marriage & Family Therapist
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2105585335
—
NV
Enumeration date
11/13/2017
Last updated
10/18/2021
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