Individual
MR. RAYMOND WADE GOURLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
313 S 16TH ST, PHILADELPHIA, PA 19102-4908
(215) 732-8244
(215) 732-8454
Mailing address
313 S 16TH ST, PHILADELPHIA, PA 19102-4908
(856) 534-7233
(215) 732-8454
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
102L00000X
Psychoanalyst
Primary
—
—
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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