Individual
LANE GORMLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LPC005090
GA
101YM0800X
Mental Health Counselor
LPC005090
GA
101YP2500X
Professional Counselor
Primary
LPC005090
GA
Other
Enumeration date
10/22/2009
Last updated
10/22/2009
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