Individual
RAQUEL GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAMFT, LPC
Contact information
Practice address
16150 N HIGH DESERT ST, NAMPA, ID 83687
(208) 546-8130
Mailing address
12807 KINAID STREET, CALDWELL, ID 83607
(208) 546-8130
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6561871
ID
106H00000X
Marriage & Family Therapist
LAMFT-9316
ID
Other
Enumeration date
04/28/2023
Last updated
10/09/2024
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