Provider Demographics
NPI:1518475805
Name:GONZALEZ, HOPE TUNNICLIFFE (PHD, NCSP)
Entity Type:Individual
Prefix:DR
First Name:HOPE
Middle Name:TUNNICLIFFE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PHD, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18547 BITTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-2741
Mailing Address - Country:US
Mailing Address - Phone:813-690-3070
Mailing Address - Fax:
Practice Address - Street 1:15961 N FLORIDA AVE.
Practice Address - Street 2:SUITE C
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-3354
Practice Address - Country:US
Practice Address - Phone:813-690-3070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-20
Last Update Date:2018-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS728103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool