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1790078517
MARY LARISSA GORMAN
SAINT PAUL, MN
NPI
1790078517
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 302977)
Enumeration Date
2011-05-26
Last Update Date
2011-05-26
Business Address
Ms. MARY LARISSA GORMAN MA, LADC
135 COLORADO ST E
SAINT PAUL, MN 55107-2244
Phone number: 651-489-7740
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Mailing Address
Ms. MARY LARISSA GORMAN MA, LADC
135 COLORADO ST E
SAINT PAUL, MN 55107-2244
Phone number: 651-489-7740
Copy
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