Individual
LORI BETH GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, LADAC
Contact information
Practice address
PICURIS PUEBLO, 201 A PUEBLO VIEW RD., PENASCO, NM 87553
(575) 587-2519
Mailing address
PO BOX 127, PENASCO, NM 87553-0127
(575) 587-2519
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAD0134501
NM
104100000X
Social Worker
Primary
M-05573
NM
Other
Enumeration date
12/05/2012
Last updated
07/20/2021
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