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General NPI Number Information
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NPI Number | 1013420892
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Entity Type | Individual
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Provider Name | DEBORA GONZALEZ LGPC
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Gender | Female
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Dates
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Enumeration Date | 11/15/2017
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Last Update Date | 11/15/2017
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Provider Practice Location Address
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Address Line | 601 50TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20019-5450
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Country | US
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Telephone | 202-399-8350
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Fax |
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Provider Business Mailing Address
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Address Line | 901 15TH ST S APT 908
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City | ARLINGTON
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State | VA
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Zip | 22202-5037
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Country | US
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Telephone | 434-426-7953
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LGPC00129
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License Number State | DC
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