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Eugene Gonzales
Specialist in Holbrook, Arizona
NPI 1811035751

Eugene Gonzales is a Specialist based in Holbrook, AZ. Eugene Gonzales practices in Holbrook, AZ. The NPI Number for Eugene Gonzales is 1811035751 and holds a License No. LISAC-1244 (Arizona).

The current practice location address for Eugene Gonzales is 105 N 5Th Ave, Holbrook, AZ and can be reached out via phone at 928-524-6126 and via fax at 928-524-6090.

Location: 105 N 5Th Ave, Holbrook, AZ, 86025-0972
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811035751
Provider Name
Eugene Gonzales
Credential
Provider Entity Type
Individual
Gender
Male
Address
105 N 5Th Ave, Holbrook, AZ, 86025-0972
Phone Number
928-524-6126
Fax Number
928-524-6090
Provider Enumeration Date
02/02/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
167332 01 AZ AHCCCS
institution
Provider Business Practice Location Address Details
Address
105 N 5Th Ave
City
Holbrook
State
Arizona
Zip
86025-2817
Phone Number
928-524-6126
Fax Number
928-524-6090
person
Provider Business Mailing Address Details
Address
105 N 5Th Ave
City
Holbrook
State
Arizona
Zip
86025-2817
Phone Number
928-524-6126
Fax Number
928-524-6090
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
256 (Arizona)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
LISAC-1244 (Arizona)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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