Individual
MRS. MIRIAM LEORA GORGBOYEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS-A, LPC-A
Contact information
Practice address
696 S SCALES ST, REIDSVILLE, NC 27320-5024
(833) 510-4329
Mailing address
615 ELSINORE PL STE 200, CINCINNATI, OH 45202-1457
(910) 442-7036
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-22221
NC
101YP2500X
Professional Counselor
A13731
NC
Other
Enumeration date
04/15/2016
Last updated
09/23/2022
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