Provider Demographics
NPI:1336777069
Name:GOMEZ, MARIA A (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:A
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1809 SANTA MARTA STREET
Mailing Address - Street 2:URB. EL PILAR
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-568-2224
Mailing Address - Fax:787-756-0144
Practice Address - Street 1:1809 SANTA MARTA STREET
Practice Address - Street 2:URB. EL PILAR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-568-2224
Practice Address - Fax:787-756-0144
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR1392103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis