Individual
MONIQUE M GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
9030 S MCCLINTOCK DR STE 105, TEMPE, AZ 85284-4553
(480) 427-7883
Mailing address
3923 S WILLOW DR, TEMPE, AZ 85282-5761
(480) 331-5227
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LMSW-16886
AZ
225700000X
Massage Therapist
Primary
MT-14892
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14892
LICENSED MASSAGE THERAPIST
AZ
Enumeration date
11/08/2020
Last updated
03/04/2022
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