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Individual

MR. MARK I GOMEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
105365 HIGHWAY102, MCLOUD, OK 74851
(405) 964-2081
Mailing address
1117 STRAKA TER, OKLAHOMA CITY, OK 73139-2518
(918) 360-9926

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
11/03/2010
Last updated
01/11/2013
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