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General NPI Number Information
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NPI Number | 1255141644
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Entity Type | Individual
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Provider Name | EVA CENDON GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 5855 JIMMY CARTER BLVD
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City | NORCROSS
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State | GA
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Zip | 30071-2929
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Country | US
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Telephone | 470-260-4178
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 LAKE RILL CT
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City | MARIETTA
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State | GA
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Zip | 30062-6158
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Country | US
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Telephone | 404-983-7301
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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 | 12603
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License Number State | GA
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