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1689248205
DERECK HUGH GONZALEZ
PROVO, UT
NPI
1689248205
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 12883692-3502)
Enumeration Date
2021-05-18
Last Update Date
2022-10-20
Business Address
Mr. DERECK HUGH GONZALEZ CSW
34 S 300 E
PROVO, UT 84606-3201
Phone number: 801-850-9147
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Mailing Address
Mr. DERECK HUGH GONZALEZ CSW
34 S 300 E
PROVO, UT 84606-3201
Phone number: 801-850-9147
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