Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 015211-1 | NY |
N | 103G00000X | Clinical Psychologist | 015211-1 | NY |
N | 103TC0700X | Clinical Psychologist | 015211-1 | NY |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 015211-1 | NY |
Y | 103TF0000X | Family Psychologist | 015211-1 | NY |
N | 103TH0004X | Health Psychologist | 015211-1 | NY |
N | 103TH0100X | Health Service | 015211-1 | NY |
N | 103TR0400X | Rehabilitation Psychologist | 015211-1 | NY |
NPI | 1548403272 |
---|---|
Provider Name | Dr. Maria Lourdes Gonzales |
First Address | Middletown, NY 10941-4028 |
Second Address | West Nyack, NY 10994-2215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2009 |
Last Update Date | 09/09/2020 |