Gonzales, Antonio Martin

Gonzales, Antonio Martin is an individual health care provider with primary practice located at 1300 Camino Sierra Vis # 125 , Santa Fe NM 87505-1007. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Gonzales, Antonio Martin can be contacted via phone (505) 467-2504.

Contact Information

Primary practice address
1300 Camino Sierra Vis # 125 Santa Fe NM 87505-1007
Phone: (505) 467-2504
Fax: (505) 467-2646
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 1041S0200X M-2120 New Mexico

Profile Details

NPI number 1992988349
LBN Legal business name Gonzales, Antonio Martin
Credentials SW
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2007
Last updated Dec 7th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992988349 NPPES
New Mexico Other M-2120 LMSW

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