Individual
NANCY GOMAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
11507 W BEKEMEYER ST, WICHITA, KS 67212-6666
(615) 400-3401
Mailing address
11507 W BEKEMEYER ST, WICHITA, KS 67212-6666
(615) 400-3401
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00637
KS
Other
Enumeration date
08/18/2010
Last updated
08/18/2010
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