Individual
KEVIN RICHARD GORMLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
30 GREENWAY ST NW STE 5, GLEN BURNIE, MD 21061-3557
(410) 760-9079
(410) 760-1121
Mailing address
30 GREENWAY ST NW STE 5, GLEN BURNIE, MD 21061-3557
(410) 760-9079
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
05041
MD
Other
Enumeration date
04/26/2013
Last updated
12/12/2017
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