| Doctor Name: | MS. LUCIANA JESSICA GORMAN |
| NPI Number: | 1346676483 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMHC |
| License Number: | 0160861 |
| Business Practice Address: | Corner Route N12 And N7 Fort Defiance, AZ - 865040649 |
| Business Phone Number: | 9287295800 |
| Business Fax Number: | 9287298502 |
| Mailing Address: | Po Box 649, FORT DEFIANCE |
| State: | AZ |
| Postal Code: | 865040649 |
| Phone Number: | 9287295800 |
| Fax Number: | 9287298502 |
| NPI Enumeration Date: | 09/20/2013 |
| NPI Last Update Date: | 09/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0160861 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |