Healthcare Provider Details

I. General information

NPI: 1508149949
Provider Name (Legal Business Name): NATALIA V GOMEZ CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NATALIA VICTORIA GOMEZ CCC-SLP

II. Dates (important events)

Enumeration Date: 09/22/2011
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 FOUNTAIN BROOK CIR STE A
CARY NC
27511-3370
US

IV. Provider business mailing address

109 FOUNTAIN BROOK CIR STE A
CARY NC
27511-3370
US

V. Phone/Fax

Practice location:
  • Phone: 919-238-9088
  • Fax: 919-375-2538
Mailing address:
  • Phone: 919-238-9088
  • Fax: 919-375-2538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number9607
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: