Individual
STEVIE GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
511 E 20TH ST, FARMINGTON, NM 87401-2105
(505) 564-3733
Mailing address
511 E 20TH ST, FARMINGTON, NM 87401-2105
(505) 564-3733
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0135701
NM
Other
Enumeration date
08/01/2011
Last updated
02/23/2012
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