Individual
JAMES RYAN GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SAC
Contact information
Practice address
1333 COLLEGE AVE, SOUTH MILWAUKEE, WI 53172-1150
(414) 775-2500
(414) 301-9328
Mailing address
1333 COLLEGE AVE, SOUTH MILWAUKEE, WI 53172-1150
(414) 775-2500
(414) 301-9328
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16552
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
19103
WI
Other
Enumeration date
02/17/2020
Last updated
04/01/2022
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