Individual
CORRINA MARIE GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
6635 E 21ST ST, INDIANAPOLIS, IN 46219-2254
(317) 608-2824
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-99528
IN
Other
Enumeration date
10/02/2020
Last updated
10/02/2020
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