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General NPI Number Information
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NPI Number | 1508570763
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Entity Type | Individual
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Provider Name | MELANIE ANN GOMEZ PSYD
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Gender | Female
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Dates
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Enumeration Date | 01/11/2023
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 1221 S CLARKSON ST
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City | DENVER
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State | CO
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Zip | 80210-1625
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Country | US
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Telephone | 720-729-8326
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Fax |
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Provider Business Mailing Address
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Address Line | 3240 S GRAPE ST
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City | DENVER
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State | CO
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Zip | 80222-7524
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Country | US
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Telephone | 322-236-1588
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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 | 0006314
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License Number State | CO
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