Provider Demographics
NPI:1841401288
Name:GONZALEZ, ERIKA (PHL)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PHL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A2 CALLE GUANINA
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-8015
Mailing Address - Country:US
Mailing Address - Phone:787-642-7268
Mailing Address - Fax:
Practice Address - Street 1:A2 CALLE GUANINA
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-8015
Practice Address - Country:US
Practice Address - Phone:787-642-7268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR691235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist