Provider Demographics
NPI:1730773086
Name:GONZALEZ-IBANEZ, MARIA ANGELES (PHD IN PSYCHOLOGY)
Entity type:Individual
Prefix:DR
First Name:MARIA ANGELES
Middle Name:
Last Name:GONZALEZ-IBANEZ
Suffix:
Gender:F
Credentials:PHD IN PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517-1431
Mailing Address - Country:US
Mailing Address - Phone:203-824-0494
Mailing Address - Fax:
Practice Address - Street 1:191 RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06517-1431
Practice Address - Country:US
Practice Address - Phone:203-824-0494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist