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General NPI Number Information
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NPI Number | 1801709282
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Entity Type | Individual
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Provider Name | JOSHUA GONZALES CCC-SLP
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Gender | Male
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | 3825 OAKRIDGE AVE NW
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City | COMSTOCK PARK
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State | MI
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Zip | 49321-9102
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Country | US
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Telephone | 616-254-5725
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Fax | 616-276-3305
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Provider Business Mailing Address
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Address Line | 3825 OAKRIDGE AVE NW
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City | COMSTOCK PARK
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State | MI
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Zip | 49321-9102
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Country | US
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Telephone | 616-254-5725
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Fax | 616-276-3305
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 7101006706
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License Number State | MI
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