Healthcare Provider Details

I. General information

NPI: 1770004277
Provider Name (Legal Business Name): MAGALI GALILEA GOMEZ MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 07/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2039 COTTAGE SAN RD
SILVER CITY NM
88061-8968
US

IV. Provider business mailing address

PO BOX 1022
SILVER CITY NM
88062-1022
US

V. Phone/Fax

Practice location:
  • Phone: 575-574-7366
  • Fax:
Mailing address:
  • Phone: 575-574-7366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: