Individual
MICHELLE GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9010 E SOUTHPORT RD, INDIANAPOLIS, IN 46259-9813
(317) 860-4722
Mailing address
765 WOOD DALE TER, GREENWOOD, IN 46142-3988
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
10279721
IN
Other
Enumeration date
10/24/2024
Last updated
11/13/2024
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