Gonzales, Jim L
Gonzales, Jim L is an sole proprietor health care provider with primary practice located at 3100 San Isidro St Nw Cochiti Es, Albuquerque NM 87107-1038. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Gonzales, Jim L can be contacted via phone (505) 345-1432.Contact Information
Primary practice address
3100 San Isidro St Nw Cochiti Es
Albuquerque NM 87107-1038
Phone: (505) 345-1432
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 2155 | New Mexico |
Profile Details
| NPI number | 1255470555 |
|---|---|
| LBN Legal business name | Gonzales, Jim L |
| Credentials | SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 5th, 2007 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255470555 | NPPES |
| New Mexico | MEDICAID | 72229 |
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