Individual
MS. LUCIANA JESSICA GORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
CORNER ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504-0649
(928) 729-5800
(928) 729-8502
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(928) 729-5800
(928) 729-8502
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0160861
NM
Other
Enumeration date
09/20/2013
Last updated
09/20/2013
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