Individual
EVAN STEVE GORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAC II
Contact information
Practice address
1322 TIMUQUANA TRL, WOODSTOCK, GA 30188-3633
(954) 654-0126
Mailing address
1322 TIMUQUANA TRL, WOODSTOCK, GA 30188-3633
(954) 654-0126
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
01849
GA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
01849
GA
Other
Enumeration date
01/17/2025
Last updated
01/17/2025
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