Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | SW00570700 | NJ |
NPI | 1003014796 |
---|---|
Provider Name | Celia Gonzalez |
First Address | Trenton, NJ 08618-4741 |
Second Address | Trenton, NJ 08618-4741 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2007 |
Last Update Date | 08/07/2007 |