Provider Demographics
NPI:1649650912
Name:GONYEA, ABBIE J (BA)
Entity type:Individual
Prefix:MRS
First Name:ABBIE
Middle Name:J
Last Name:GONYEA
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MS
Other - First Name:ABBIE
Other - Middle Name:J
Other - Last Name:ALMANZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:4538 W CRAIG RD
Mailing Address - Street 2:SUITE 290
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-2508
Mailing Address - Country:US
Mailing Address - Phone:702-486-5503
Mailing Address - Fax:
Practice Address - Street 1:4538 W CRAIG RD
Practice Address - Street 2:SUITE 290
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-2508
Practice Address - Country:US
Practice Address - Phone:702-486-5503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker