| Kathleen Gorman-ezell, Ph.d, Lisw, Llc | |
|
499 Village Park Dr Powell OH 43065-6605 | |
| (614) 745-9484 | |
| Not Available |
| Full Name | Kathleen Gorman-ezell, Ph.d, Lisw, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 499 Village Park Dr, Powell, Ohio |
| Authorized Official Name and Position | Kathleen Gorman-ezell (PRESIDENT) |
| Authorized Official Contact | 4193449940 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen Gorman-ezell, Ph.d, Lisw, Llc 3323 Windy Forest Ln Powell OH 43065-7381 Ph: () - | Kathleen Gorman-ezell, Ph.d, Lisw, Llc 499 Village Park Dr Powell OH 43065-6605 Ph: (614) 745-9484 |
| NPI Number | 1194007880 |
|---|---|
| Provider Enumeration Date | 09/19/2011 |
| Last Update Date | 09/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194007880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | I.0700024-SUPV (Ohio) | Primary |
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