Provider Demographics
NPI:1174231823
Name:GONZALEZ, AMINA TALONI
Entity type:Individual
Prefix:
First Name:AMINA
Middle Name:TALONI
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7009 RIVER ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-7345
Mailing Address - Country:US
Mailing Address - Phone:404-725-7745
Mailing Address - Fax:
Practice Address - Street 1:7009 RIVER ESTATES DR
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-7345
Practice Address - Country:US
Practice Address - Phone:404-725-7745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician