| NPI | 1134631310 |
|---|---|
| Former Name | MARY GOMEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 095296) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 18789) |
| 104100000X Social Worker (Licence: NY 086207) | |
| Enumeration Date | 2017-10-28 |
| Last Update Date | 2023-05-01 |