Healthcare Provider Details

I. General information

NPI: 1154251668
Provider Name (Legal Business Name): HADYA GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W LAS CRUCES AVE
LAS CRUCES NM
88005-1804
US

IV. Provider business mailing address

12591 BARBARO WAY
EL PASO TX
79928-2372
US

V. Phone/Fax

Practice location:
  • Phone: 575-249-0390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: