Provider Demographics
NPI:1831268259
Name:GONZALEZ, NAYDU OSORIO (OT)
Entity type:Individual
Prefix:MS
First Name:NAYDU
Middle Name:OSORIO
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:NAYDU
Other - Middle Name:
Other - Last Name:OSORIO OSORIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:3804 KLERNER LN
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-2038
Mailing Address - Country:US
Mailing Address - Phone:502-851-1082
Mailing Address - Fax:888-309-6379
Practice Address - Street 1:3804 KLERNER LN
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2038
Practice Address - Country:US
Practice Address - Phone:502-851-1082
Practice Address - Fax:888-309-6379
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004398A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist