Provider Demographics
NPI:1992179543
Name:GONZALEZ, HECTOR
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6123
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-0930
Mailing Address - Country:US
Mailing Address - Phone:401-999-8631
Mailing Address - Fax:
Practice Address - Street 1:59 JOHN H CHAFEE BLVD
Practice Address - Street 2:APT. 317
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-1179
Practice Address - Country:US
Practice Address - Phone:401-999-8631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor