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Provider Information for 1568055101

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

ALONDRA GOMEZ

Gender: FEMALE

Individual NPI: 1568055101

Calendar   Last Updated:  2021-02-15
  Certification Date:  2021-02-15

Details

Name Value
NPI 1568055101
Enumeration Date 2021-02-15
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 27777 INKSTER RD
FARMINGTON HILLS, MI 48334-5310
United States

Phone: 248-436-4400 | Fax:
View Map External Link
Primary Practice Address 27777 INKSTER RD
FARMINGTON HILLS, MI 48334-5310
United States

Phone: 248-436-4400 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 106S00000X - Behavior Technician