Provider Demographics
NPI:1538460761
Name:GONZALEZ, VALERY ANN (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:VALERY
Middle Name:ANN
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14002 E 21ST ST STE 200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74134-1412
Mailing Address - Country:US
Mailing Address - Phone:918-628-2760
Mailing Address - Fax:
Practice Address - Street 1:14002 E 21ST ST STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74134-1412
Practice Address - Country:US
Practice Address - Phone:918-628-2760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical