Individual
MRS. MELISSA ANN HERNANDEZ-GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
503 DAVIDSON ST, ELDORADO, IL 62930-2430
(618) 841-0898
Mailing address
503 DAVIDSON ST, ELDORADO, IL 62930-2430
(618) 841-0898
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
2457498
IL
Other
Enumeration date
10/16/2010
Last updated
10/16/2010
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