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General NPI Number Information
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NPI Number | 1306171723
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Entity Type | Individual
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Provider Name | OSVELIA GONZALEZ DEEDS PHD
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Gender | Female
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Dates
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Enumeration Date | 10/04/2009
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 2580 HIGHWAY 95 STE 213G
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442-7331
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Country | US
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Telephone | 505-850-5314
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Fax | 928-438-2037
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Provider Business Mailing Address
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Address Line | PO BOX 62384
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City | BOULDER CITY
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State | NV
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Zip | 89006-2384
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Country | US
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Telephone | 505-850-5314
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Fax | 928-438-2037
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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 | 1095
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License Number State | NM
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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 | PY7898
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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 | 4693
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License Number State | AZ
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