Provider Demographics
NPI:1821548553
Name:GONZALES, CHRISTINA (RBT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:GONZALES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:PARRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1213 HACHITA DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-6262
Mailing Address - Country:US
Mailing Address - Phone:575-635-9481
Mailing Address - Fax:
Practice Address - Street 1:1213 HACHITA DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88012-6262
Practice Address - Country:US
Practice Address - Phone:575-635-9481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician