Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 06-03P | AR |
Y | 103TC0700X | Clinical Psychologist | 06-03P | AR |
N | 103TA0700X | Adult Development & Aging Psychologist | 06-03P | AR |
N | 103G00000X | Clinical Psychologist | 06-03P | AR |
N | 103TC0700X | Clinical Psychologist | 06-03P | AR |
NPI | 1063502532 |
---|---|
Provider Name | Dr. Courtney O. Ghormley |
First Address | Little Rock, AR 72205-3013 |
Second Address | Little Rock, AR 72205-3013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/01/2008 |