Individual provider · NPI-1
Nicole Vigoda Gonzalez
Psychologist, Clinical · Armonk, NY
NPI number1639585276
StatusActive
Last updated in NPPESNov 18, 2020
Details
- NPI
- 1639585276
- Entity type
- Individual (NPI-1)
- Name
- Nicole Vigoda Gonzalez
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 3, 2014
- Certification date
- Nov 18, 2020
- Last updated
- Nov 18, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 022932 | NY | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
1 Hunter AveArmonk, NY 10504-2025
Phone 646-320-6055
Mailing address
11 Miller CirArmonk, NY 10504-1357
Phone 646-320-6055
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