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NPI Code Detail

MEDICARE: NANCY GOMEZ

MEDICARE: NANCY GOMEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst
2106S00000XBehavior Technician
3103K00000XBehavior Analyst12153387TN

General Provider Information

NPI Number : 1922668490
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY GOMEZ
Provider Business Mailing Address
First Line : 1535 N MOUNT JULIET RD
Second Line :
City : MT JULIET
State : TN
Zip : 37122-3315
Country : US
Telephone Number : 615-560-6622
Fax Number : 615-560-6636
Provider Business Practice Location Address
First Line : 1535 N MOUNT JULIET RD
Second Line :
City : MT JULIET
State : TN
Zip : 37122-3315
Country : US
Telephone Number : 615-560-6622
Fax Number : 615-560-6636
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2019
Last Update Date : 03/03/2022

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Directions to “ NANCY GOMEZ ” Practice Location

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