Individual
KENIA LOIRET GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
221 LONGWOOD AVE, BOSTON, MA 02115-5804
(617) 732-5500
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
10790
MA
103TC0700X
Clinical Psychologist
Primary
10790
MA
103TC2200X
Clinical Child & Adolescent Psychologist
10790
MA
Other
Enumeration date
03/30/2011
Last updated
09/01/2020
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