Individual
GARY R HIVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
2111 W HWY 377, GRANBURY, TX 76048-5627
(817) 573-6002
(817) 573-6009
Mailing address
2111 W HWY 377, GRANBURY, TX 76048-5627
(817) 573-6002
(817) 573-6009
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
9409
TX
Other
Enumeration date
02/22/2008
Last updated
02/22/2008
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