Provider Demographics
NPI:1962631945
Name:GONZALEZ, AALYSHA MICHELLE (LMHC, LPC)
Entity Type:Individual
Prefix:
First Name:AALYSHA
Middle Name:MICHELLE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5960 SNOWDROP WAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-4511
Mailing Address - Country:US
Mailing Address - Phone:918-740-0393
Mailing Address - Fax:
Practice Address - Street 1:5960 SNOWDROP WAY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-4511
Practice Address - Country:US
Practice Address - Phone:918-740-0393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4146101YM0800X
FLMH9697101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health