Individual
MISS ANDREA X GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
14625 NE 23RD ST., CHOCTAW, OK 73020-0695
(405) 390-8131
(405) 390-8134
Mailing address
PO BOX 695, CHOCTAW, OK 73020-0695
(405) 390-8131
(405) 390-8134
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
334
OK
Other
Enumeration date
10/24/2006
Last updated
07/09/2007
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