Brian Jesse Gomez

NPI #1093214520 in Lyons, Illinois

Provider Information

NPI Number: 1093214520
Entity Type: Individual
Name: Brian Jesse Gomez
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Feb 10, 2018
Last Updated: Feb 10, 2018

Practice Location

Address: 4220 FISHERMANS TER
City: Lyons
State: Illinois
ZIP Code: 60534-1402
Phone: (708) 612-2756

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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