Provider Demographics
NPI:1720362171
Name:GONZALEZ TOLEDO, BRENDA IRIS (MSW-CLINIC)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:IRIS
Last Name:GONZALEZ TOLEDO
Suffix:
Gender:F
Credentials:MSW-CLINIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 COND EL ATLANTICO APT 1210
Mailing Address - Street 2:LEVITTOWN,
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4222
Mailing Address - Country:US
Mailing Address - Phone:787-908-0617
Mailing Address - Fax:
Practice Address - Street 1:1 COND EL ATLANTICO APT 1210
Practice Address - Street 2:LEVITTOWN,
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-4222
Practice Address - Country:US
Practice Address - Phone:787-908-0617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR98601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical