| Doctor Name: | CLUNY GOMBAR |
| NPI Number: | 1013377183 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 002911 |
| Business Practice Address: | 475 Clinton Ave Bridgeport, CT - 066051700 |
| Business Phone Number: | 2033684291 |
| Business Fax Number: | 2033689167 |
| Mailing Address: | 475 Clinton Ave, BRIDGEPORT |
| State: | CT |
| Postal Code: | 066051700 |
| Phone Number: | 2033684291 |
| Fax Number: | 2033689167 |
| NPI Enumeration Date: | 03/02/2016 |
| NPI Last Update Date: | 03/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 002911 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |