Provider Demographics
NPI:1740928324
Name:MFG PSYCHOLOGICAL SERVICES, PLLC
Entity type:Organization
Organization Name:MFG PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:F
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LSOTP
Authorized Official - Phone:512-402-3052
Mailing Address - Street 1:314 E HIGHLAND MALL BLVD STE 252
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-3766
Mailing Address - Country:US
Mailing Address - Phone:512-402-3052
Mailing Address - Fax:
Practice Address - Street 1:314 E HIGHLAND MALL BLVD STE 252
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3766
Practice Address - Country:US
Practice Address - Phone:512-402-3052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty