Individual
CRYSTAL GORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
196 E EMMITT AVE, WAVERLY, OH 45690-1334
(740) 947-6727
Mailing address
314 WADSWORTH AVE, WAVERLY, OH 45690-9380
(740) 222-1149
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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