Most Relevant Information
Provider Data
| NPI Number: | 1003287798 |
| Provider Name: | MICHELLE LUPITA GONZALEZ CPRSS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/07/2015 |
| Last Updated: | 10/07/2015 |
Provider Practice Location
5714 S WESTERN AVE
OKLAHOMA CITY
OK
731094515
Practice Location Phone/Fax
| Phone: | 4056011154 |
| Fax: | 4056011183 |
Provider Mailing Location
5714 S WESTERN AVE
OKLAHOMA CITY
OK
731094515
Provider Mailing Phone/Fax
| Phone: | 4056011154 |
| Fax: | 4056011183 |