Provider Demographics
NPI:1275589467
Name:GONZALEZ, ADA LUZ (PHD, LMFT)
Entity Type:Individual
Prefix:
First Name:ADA
Middle Name:LUZ
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 TEAK CT
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4007
Mailing Address - Country:US
Mailing Address - Phone:302-399-3915
Mailing Address - Fax:
Practice Address - Street 1:91 WOLF CREEK BLVD STE 1
Practice Address - Street 2:CHILDREN AND FAMILIES FIRST
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4914
Practice Address - Country:US
Practice Address - Phone:302-674-8384
Practice Address - Fax:302-678-5634
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5143106H00000X
DEFT-0000013106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist