Most Relevant Information
Provider Data
| NPI Number: | 1003195421 |
| Provider Name: | MARISELA GONZALES |
| Entity Type: | Individual |
| Taxonomy Code: | 222Q00000X |
| Specialty: | Developmental Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/16/2011 |
| Last Updated: | 10/26/2015 |
Provider Practice Location
2535 W CHEYENNE AVE
#104
NORTH LAS VEGAS
NV
890328929
Practice Location Phone/Fax
| Phone: | 7022022567 |
| Fax: |
Provider Mailing Location
5575 SIMMONS ST
#1-363
NORTH LAS VEGAS
NV
890319009
Provider Mailing Phone/Fax
| Phone: | 7022022567 |
| Fax: |