Individual
DEVON KB GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 457, GANADO, AZ 86505-0457
(928) 755-4586
(928) 755-4747
Mailing address
PO BOX 52, CHINLE, AZ 86503-0052
(480) 401-6166
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-22971
AZ
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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