Individual
FERNANDO GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LMHC
Contact information
Practice address
5305 MCNUTT RD, SANTA TERESA, NM 88008-9685
(575) 882-5100
(575) 882-1151
Mailing address
5305 MCNUTT RD, SANTA TERESA, NM 88008-9685
(575) 882-5100
(575) 882-1151
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
T0170901
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64153274
—
NM
Enumeration date
12/18/2014
Last updated
12/18/2014
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