Jade Gomillion

NPI #1992485262 in Longview, Texas

Provider Information

NPI Number: 1992485262
Entity Type: Individual
Name: Jade Gomillion
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Jul 21, 2023
Last Updated: Jul 21, 2023

Practice Location

Address: 701 GLENCREST LN
City: Longview
State: Texas
ZIP Code: 75601-5145
Phone: (903) 686-9941

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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