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General NPI Number Information
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NPI Number | 1124192281
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Entity Type | Individual
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Provider Name | TWAIN GONZALES PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 04/24/2019
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Provider Practice Location Address
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Address Line | 219 WASHINGTON AVE
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City | NEWTOWN
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State | PA
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Zip | 18940-1941
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Country | US
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Telephone | 302-430-9997
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Fax |
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Provider Business Mailing Address
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Address Line | 219 WASHINGTON AVE
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City | NEWTOWN
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State | PA
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Zip | 18940-1941
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Country | US
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Telephone | 302-430-9997
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Fax | 302-644-4909
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | B1-0000865
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY8532
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS005925L
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License Number State | PA
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