Individual
LEO GORMLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRADC
Contact information
Practice address
6763 PAGE AVE # MO, SAINT LOUIS, MO 63133-1635
(314) 206-3910
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11787
MO
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Enumeration date
11/04/2014
Last updated
03/22/2022
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