Individual
KENNETH W GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
852 MERRIMON AVE, ASHEVILLE, NC 28804-2405
(828) 251-6091
(828) 251-6911
Mailing address
852 MERRIMON AVE, ASHEVILLE, NC 28804-2405
(828) 251-6091
(828) 251-6911
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1436
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03400
BLUE CROSS AND BLUE SHIELD
NC
05
—
3403418
—
NC
Enumeration date
04/03/2007
Last updated
06/21/2012
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