FAWN GONZALES LCSW LLC

MEDFORD, OR
NPI1417322231
Entity TypeOrganization
Authorized ContactFAWN GONZALES
Owner
541-944-7711
Organization Subpart ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: OR  5212)
Enumeration Date2015-12-04
Last Update Date2015-12-04
Business Address
FAWN GONZALES LCSW LLC
14 COTTAGE ST
MEDFORD, OR 97504-7332
Phone number: 541-944-7711
Mailing Address
FAWN GONZALES LCSW LLC
1820 W BALBOA BLVD
NEWPORT BEACH, CA 92663-4515
Phone number: 541-944-7711