Provider Demographics
NPI:1912068115
Name:GONZALEZ, NORMA IRIS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:IRIS
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CONDOMINIO PASEOMONTE 381
Mailing Address - Street 2:APT. 1404
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:218 BROOKS ST. BLGD. 21
Practice Address - Street 2:RODRIGUEZ ARMY HEALTH CLINIC
Practice Address - City:FORT BUCHANAN
Practice Address - State:PR
Practice Address - Zip Code:00934-3400
Practice Address - Country:US
Practice Address - Phone:787-707-4393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1442103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist