Provider Demographics
NPI:1639433527
Name:GORMAN, STEPHANIE ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANN
Last Name:GORMAN
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:CENTER FOR NEUROPSYCHOLOGICAL
Mailing Address - Street 2:MSC09 5030-1 UNM
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-8833
Mailing Address - Fax:505-272-8316
Practice Address - Street 1:CENTER FOR NEUROPSYCHOLOGICAL
Practice Address - Street 2:MSC09 5030-1 UNM
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-8833
Practice Address - Fax:505-272-8316
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2023-07-14
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Provider Licenses
StateLicense IDTaxonomies
NM1364103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist