Individual
DENNIS R. GOURLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
480 PIERCE STREET, SUITE 112, KINGSTON, PA 18704-5512
(570) 714-0890
(570) 714-0890
Mailing address
480 PIERCE STREET, SUITE 112, KINGSTON, PA 18704-5512
(570) 714-0890
(570) 714-0890
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW013873
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101659198
—
PA
Enumeration date
10/05/2006
Last updated
04/16/2015
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