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General NPI Number Information
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NPI Number | 1447503032
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Entity Type | Individual
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Provider Name | YADIRA GOMEZ PSY.D
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Gender | Female
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Dates
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Enumeration Date | 10/19/2012
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Last Update Date | 05/10/2017
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Provider Practice Location Address
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Address Line | CARR 402 KM 1.8
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City | ANASCO
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State | PR
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Zip | 00610
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Country | US
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Telephone | 787-464-3486
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2187
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City | ANASCO
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State | PR
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Zip | 00610-2187
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Country | US
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Telephone | 787-464-3486
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3107
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License Number State | PR
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