Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics |
NPI | 1134739345 |
---|---|
Provider Name | Mrs. Heather Leigh Gonzalez |
First Address | Wexford, PA 15090-7835 |
Second Address | Cranberry Township, PA 16066-7605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2020 |
Last Update Date | 03/08/2020 |