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NPI Code Detail

MEDICARE: CHRISTOPHER GONZALEZ

MEDICARE: CHRISTOPHER GONZALEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1164209045
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER GONZALEZ
Provider Business Mailing Address
First Line : 7712 UNICORN TAPESTRY CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-0437
Country : US
Telephone Number : 734-945-6473
Fax Number : 702-447-5171
Provider Business Practice Location Address
First Line : 7712 UNICORN TAPESTRY CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-0437
Country : US
Telephone Number : 734-945-6473
Fax Number : 702-447-5171
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2023
Last Update Date : 09/13/2023

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Directions to “ CHRISTOPHER GONZALEZ ” Practice Location

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