| Gonzales Lcsw Llc | |
|
61 E 1600 N Genola UT 84655-5090 | |
| (385) 434-1274 | |
| Not Available |
| Full Name | Gonzales Lcsw Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 61 E 1600 N, Genola, Utah |
| Authorized Official Name and Position | Morgan Gonzales (OWNER) |
| Authorized Official Contact | 3854341274 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gonzales Lcsw Llc 61 E 1600 N Genola UT 84655-5090 Ph: () - | Gonzales Lcsw Llc 61 E 1600 N Genola UT 84655-5090 Ph: (385) 434-1274 |
| NPI Number | 1164984456 |
|---|---|
| Provider Enumeration Date | 04/04/2019 |
| Last Update Date | 04/04/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164984456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Wasatch Front Trail Venture Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 61 E 1600 N, Genola, UT 84655 Phone: 435-513-2715 |