Provider Demographics
NPI:1578192233
Name:GONZALEZ, ADRIANNA LEIGH
Entity Type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:LEIGH
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1168 ELISA GINA TER
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-7424
Mailing Address - Country:US
Mailing Address - Phone:404-992-4578
Mailing Address - Fax:
Practice Address - Street 1:2810 PREMIERE PKWY STE 500
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-8912
Practice Address - Country:US
Practice Address - Phone:866-750-5554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-05
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst