Individual
AMANDA ANN GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
3112 HENNEPIN AVE, MINNEAPOLIS, MN 55408-2619
(612) 395-4967
Mailing address
621 W LAKE ST STE 350, MINNEAPOLIS, MN 55408-2952
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
21549
MN
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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