Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MS. LAURA LISA GONZALEZ, M.A
Active Sole ProprietorIntellectual Disabilities Residential Treatment Facility · DAVISON, MI
Registration Details
- NPI Number
- 1770199507
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 17, 2020 (5.5936418902891 yrs)
- Last Updated
- Sep 17, 2020
- License
-
AS25.293461 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
7134 BLANKENSHIP CIRDAVISON, MI, 484232317Browse MI providers · Browse ZIP 48423
- Phone
- 8107427713
- Fax
- 8104079198
- Primary Specialty
-
Intellectual Disabilities Residential Treatment Facility
320600000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.