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General NPI Number Information
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NPI Number | 1932448545
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Entity Type | Individual
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Provider Name | MARIBEL GONZALEZ PHD
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Gender | Female
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 02/04/2013
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Provider Practice Location Address
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Address Line | 1510 AVE. ROOSEVELT MEZANINE, ED. TRIPLE S PLAZA
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City | GUAYNABO
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State | PR
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Zip | 00968
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Country | US
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Telephone | 787-529-3050
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Fax |
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Provider Business Mailing Address
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Address Line | 1353 AVE LUIS VIGOREAUX 580 PMB
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City | GUAYNABO
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State | PR
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Zip | 00966-2715
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Country | US
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Telephone | 787-529-3050
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2110
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 2110
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License Number State | PR
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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 | 2110
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License Number State | PR
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