Provider Demographics
NPI:1609179183
Name:GONZALEZ, ZULMA DANAE
Entity Type:Individual
Prefix:
First Name:ZULMA
Middle Name:DANAE
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 1:30 OAK RD
Mailing Address - Street 2:
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-5628
Mailing Address - Country:US
Mailing Address - Phone:617-323-0754
Mailing Address - Fax:
Practice Address - Street 1:30 OAK RD
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-5628
Practice Address - Country:US
Practice Address - Phone:617-323-0754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor