Individual
JENNIFER GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
71 LOUISIANA AVE, BRIDGEPORT, CT 06610-1542
(203) 923-7792
Mailing address
71 LOUISIANA AVE, BRIDGEPORT, CT 06610-1542
(203) 923-7792
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1616
CT
Other
Enumeration date
08/19/2015
Last updated
08/19/2015
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