Provider Demographics
NPI:1952106874
Name:GONZALEZ, MICHELLE LUJAN (BEHAVIOR HEALTH TECH)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LUJAN
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:BEHAVIOR HEALTH TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 ETHAN WAY APT 205
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-0144
Mailing Address - Country:US
Mailing Address - Phone:828-707-7507
Mailing Address - Fax:
Practice Address - Street 1:218 ETHAN WAY APT 205
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-0144
Practice Address - Country:US
Practice Address - Phone:828-707-7507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician