Individual
DR. MICHAEL N GOMILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LPC
Contact information
Practice address
5625 FAIRWAY DR, ZACHARY, LA 70791-2313
(318) 235-3802
Mailing address
5625 FAIRWAY DR, ZACHARY, LA 70791-2313
(318) 235-3661
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
3353
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
3353
LA
101YM0800X
Mental Health Counselor
3353
LA
101YP2500X
Professional Counselor
Primary
3353
LA
Other
Enumeration date
01/02/2007
Last updated
06/01/2019
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