Provider Demographics
NPI:1376130732
Name:GOMEZ, NINFA (SLPA)
Entity Type:Individual
Prefix:MS
First Name:NINFA
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3028 SCOTLAND DR APT 2
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-2266
Mailing Address - Country:US
Mailing Address - Phone:956-329-3100
Mailing Address - Fax:
Practice Address - Street 1:508 W INTERSTATE 2 STE 3
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6563
Practice Address - Country:US
Practice Address - Phone:956-510-8777
Practice Address - Fax:956-854-4338
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX323902355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant