Individual
MS. AGILDA GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7250 NW 177TH ST APT 206, HIALEAH, FL 33015-6238
(786) 343-3012
Mailing address
7250 NW 177TH ST APT 206, HIALEAH, FL 33015-6238
(786) 343-3012
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
20-131868
FL
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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