Ethan J Gonsalves, RADT
NPI #1053035402 in San Luis Obispo, California
Provider Information
- NPI Number
- 1053035402
- Entity Type
- Individual
- Name
- Ethan J Gonsalves, RADT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Credential
- RADT
- Enumeration Date
- Sep 29, 2022
- Last Updated
- Sep 29, 2022
Practice Location
- Address
- 34 PRADO
- City
- San Luis Obispo
- State
- California
- ZIP Code
- 93401
- Phone
- (805) 519-1405
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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