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General NPI Number Information
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NPI Number | 1639331044
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Entity Type | Individual
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Provider Name | ROSA GONZALEZ LMHC
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Gender | Female
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 04/10/2009
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Provider Practice Location Address
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Address Line | 16969 NW 67TH AVE SUITE.202
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City | HIALEAH
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State | FL
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Zip | 33015-4214
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Country | US
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Telephone | 786-553-3596
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Fax | 954-239-8041
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Provider Business Mailing Address
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Address Line | 15476 NW 77TH CT SUITE 118
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City | MIAMI LAKES
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State | FL
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Zip | 33016-5823
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Country | US
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Telephone | 786-553-3596
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Fax | 954-239-8041
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9435
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License Number State | FL
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