Provider Demographics
NPI:1639063035
Name:GONZALEZ GOMEZ, CARILLE (THL)
Entity type:Individual
Prefix:
First Name:CARILLE
Middle Name:
Last Name:GONZALEZ GOMEZ
Suffix:
Gender:F
Credentials:THL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB RIVERAS DEL BUCANA 2535 CALLE FLORIN
Mailing Address - Street 2:TERAPIADELHABLA@YAHOO.COM
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00731-0073
Mailing Address - Country:US
Mailing Address - Phone:939-286-6468
Mailing Address - Fax:
Practice Address - Street 1:URB RIVERAS DEL BUCANA
Practice Address - Street 2:2535 CALLE FLORIN
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00731-0073
Practice Address - Country:US
Practice Address - Phone:939-286-6486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10702355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant