Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner | ||
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1225319668 |
---|---|
Provider Name | Ms. Maribel Gonzalez |
First Address | Las Vegas, NV 89146-5306 |
Second Address | Las Vegas, NV 89146-5306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2011 |
Last Update Date | 10/07/2014 |