NPI | 1528206182 |
---|---|
Former Name | SHELLY GOMEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 8846) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MS C7570) |
Enumeration Date | 2009-02-04 |
Last Update Date | 2024-09-11 |