Individual
AMANDA P GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS-CCC-SLP
Contact information
Practice address
4530 NELSON BROGDON BLVD STE C, BUFORD, GA 30518
(678) 820-9606
(844) 820-9616
Mailing address
4530 NELSON BROGDON BLVD STE C, BUFORD, GA 30518-5407
(678) 820-9606
(844) 820-9616
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
006456
GA
235Z00000X
Speech-Language Pathologist
Primary
SLP 006456
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003134692A
—
GA
05
—
198576913D
—
GA
Enumeration date
06/03/2007
Last updated
04/21/2022
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