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Mr. Jonathan Gonzales Makua
Mental Health Counselor in Ketchikan, Alaska
NPI 1285239905

Jonathan Gonzales Makua is a Mental Health Counselor based in Ketchikan, AK and is specialized in Mental Health. Jonathan Gonzales Makua practices in Ketchikan, AK. The NPI Number for Jonathan Gonzales Makua is 1285239905 and holds a License No. (Alaska).

The current practice location address for Jonathan Gonzales Makua is 2514 First Ave, Ketchikan, AK and can be reached out via phone at 907-225-4664 and via fax at 907-885-6613.

Location: 2514 First Ave, Ketchikan, AK, 99901-2475
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1285239905
Provider Name
Jonathan Gonzales Makua
Credential
Provider Entity Type
Individual
Gender
Male
Address
2514 First Ave, Ketchikan, AK, 99901-2475
Phone Number
907-225-4664
Fax Number
907-885-6613
Provider Enumeration Date
12/01/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1021118 05 AK
1584706 05 AK
institution
Provider Business Practice Location Address Details
Address
2514 First Ave
City
Ketchikan
State
Alaska
Zip
99901-5804
Phone Number
907-225-4664
Fax Number
907-885-6613
person
Provider Business Mailing Address Details
Address
2514 First Ave
City
Ketchikan
State
Alaska
Zip
99901-5804
Phone Number
907-225-4664
Fax Number
907-885-6613
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
(Alaska)
Definition
Definition to come...
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