Provider Demographics
NPI:1588188437
Name:GONYIER, RENEE SUZANNE (LMFT)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:SUZANNE
Last Name:GONYIER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 AVENIDA RINCON UNIT 101
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87506-3521
Mailing Address - Country:US
Mailing Address - Phone:505-603-6289
Mailing Address - Fax:
Practice Address - Street 1:411 SAINT MICHAELS DR STE 5
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7655
Practice Address - Country:US
Practice Address - Phone:505-603-6289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0118371106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist