Individual
ROSANNA DIANE GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
722 TOWN EAST MAIN ST, CARNEGIE, OK 73015-9012
(580) 574-4183
Mailing address
PO BOX 1185, CARNEGIE, OK 73015-1185
(580) 919-8870
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
10450
OK
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487125910
—
OK
Enumeration date
12/10/2018
Last updated
09/08/2022
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