Provider Demographics
NPI:1134667371
Name:GONZALEZ, JANELLE (MSW)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3174 RIVER BRANCH CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7601
Mailing Address - Country:US
Mailing Address - Phone:407-758-1031
Mailing Address - Fax:
Practice Address - Street 1:3174 RIVER BRANCH CIR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7601
Practice Address - Country:US
Practice Address - Phone:407-758-1031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-08
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical