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NPI Code Detail

MEDICARE: STEPHANIE JEANNETTE GONZALEZ BEHAVIOR SPECIALIST

MEDICARE: STEPHANIE JEANNETTE GONZALEZ BEHAVIOR SPECIALIST
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
1101Y00000XCounselorCG70113490WA

General Provider Information

NPI Number : 1508705799
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE JEANNETTE GONZALEZ BEHAVIOR SPECIALIST
Provider Business Mailing Address
First Line : 3754 W INDIAN TRAIL RD
Second Line :
City : SPOKANE
State : WA
Zip : 99208-4736
Country : US
Telephone Number : 509-559-3100
Fax Number :
Provider Business Practice Location Address
First Line : 3754 W INDIAN TRAIL RD
Second Line :
City : SPOKANE
State : WA
Zip : 99208-4736
Country : US
Telephone Number : 509-559-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2026
Last Update Date : 03/25/2026

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