Individual
NICOLE GORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-3163
Mailing address
2580 HOMER LAKE RD, HOMER, IL 61849-9770
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.014863
IL
Other
Enumeration date
04/28/2015
Last updated
04/28/2015
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