Individual
MISS TRACY LYNN GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD LP
Contact information
Practice address
730 N MACOMB ST STE 200, MONROE, MI 48162-2904
(734) 240-1760
Mailing address
1783 COUNCIL AVE, LINCOLN PARK, MI 48146-1206
(313) 388-6466
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301018298
MI
Other
Enumeration date
12/26/2007
Last updated
03/28/2020
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