Individual
ELAINE SOUZA GOMIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.P.T.
Contact information
Practice address
4289 N 400 W, LEHI, UT 84043-4997
(954) 871-1307
Mailing address
4289 N 400 W, LEHI, UT 84043-4997
(954) 871-1307
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
PT28315
FL
2251P0200X
Pediatric Physical Therapist
026072
NY
2251P0200X
Pediatric Physical Therapist
40QA01115300
NJ
Other
Enumeration date
09/22/2008
Last updated
03/25/2025
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