Individual
MATTHEW GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
72 BLUE RIDGE LN, BURNSVILLE, NC 28714-7270
(828) 682-2111
(828) 682-9323
Mailing address
6 S BEAR CREEK RD, ASHEVILLE, NC 28806-1502
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-20711
NC
Other
Enumeration date
07/24/2014
Last updated
07/24/2014
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