NPI 1194466029

Heidi Jean Gonzalez

Practitioner Massage Therapist Wauwatosa, WI

Practice location

Address: 12100 W Dearbourn Ave, Wauwatosa, WI 53226-3840
Phone: (414) 870-3548
Mailing address: 726 S 111th St, Milwaukee, WI 53214-2331

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 11040-146 (WI)

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Registry record

NPI: 1194466029
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Apr 2022
Record last updated: 5 Apr 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.