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General NPI Number Information
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NPI Number | 1952614166
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Entity Type | Individual
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Provider Name | JO ANN GONZALEZ TALER LPC
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Gender | Female
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Dates
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Enumeration Date | 07/16/2010
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Last Update Date | 07/16/2010
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Provider Practice Location Address
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Address Line | 3307 W DAVIS ST SUITE C
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City | CONROE
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State | TX
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Zip | 77304-1861
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Country | US
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Telephone | 832-715-8601
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Fax | 936-647-1395
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Provider Business Mailing Address
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Address Line | 2038 S SHORE BLVD
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City | MONTGOMERY
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State | TX
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Zip | 77356-4807
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Country | US
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Telephone | 832-715-8601
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Fax | 936-647-1395
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 62232
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License Number State | TX
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