Individual
DUSTIN ARIEL GHORMLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
401 E CYPRESS AVE, LOMPOC, CA 93436-6806
(805) 864-1940
(805) 865-1954
Mailing address
401 E CYPRESS AVE, LOMPOC, CA 93436-6806
(805) 864-1940
(805) 865-1954
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
38175
CA
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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