Healthcare Provider Details

I. General information

NPI: 1538931217
Provider Name (Legal Business Name): DANIELA MARIA GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 WAKE FOREST RD STE 349
RALEIGH NC
27609-0010
US

IV. Provider business mailing address

13143 HAMPTON BAY LN
CHARLOTTE NC
28262-3080
US

V. Phone/Fax

Practice location:
  • Phone: 980-890-7522
  • Fax:
Mailing address:
  • Phone: 980-844-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP018980
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: