| NPI | 1508325903 |
|---|---|
| Former Name | NICHOLAS BENNETT GONZALEZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY33288) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO PSY.0006612) |
| 103T00000X Psychologist (Licence: WV 1336) | |
| 103T00000X Psychologist (Licence: CA PSY33288) | |
| 103TC0700X Psychologist, Clinical (Licence: CO PSY.0006612) | |
| 103TC1900X Psychologist, Counseling (Licence: CA PSY33288) | |
| 103TC1900X Psychologist, Counseling | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CA PSY33288) | |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2025-08-27 |