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General NPI Number Information
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NPI Number | 1518475805
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Entity Type | Individual
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Provider Name | HOPE TUNNICLIFFE GONZALEZ PH.D., NCSP
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Gender | Female
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Dates
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Enumeration Date | 01/20/2018
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Last Update Date | 01/20/2018
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Provider Practice Location Address
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Address Line | 15961 N FLORIDA AVE. SUITE C
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City | LUTZ
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State | FL
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Zip | 33549-3354
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Country | US
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Telephone | 813-690-3070
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Fax |
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Provider Business Mailing Address
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Address Line | 18547 BITTERN AVE
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City | LUTZ
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State | FL
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Zip | 33558-2741
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Country | US
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Telephone | 813-690-3070
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | SS728
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License Number State | FL
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