Individual provider · Type 1 NPI

Wayne Bruce Gore, MED, CSAC

Addiction (Substance Use Disorder) Counselor · Leesburg, VA

NPI number 1164520029 Active

Practice location

102 Heritage Way NE Ste 302
Leesburg, VA 20176-4544

Call (703) 771-5100 Map

Fax (703) 777-0170

Mailing address

37202 Bolyn Rd
Purcellville, VA 20132-4111

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X0710101151 (VA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1164520029

Wayne Bruce Gore, MED, CSAC's National Provider Identifier is 1164520029, issued on Sep 21, 2006. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Leesburg, VA. The record was last updated on Jul 8, 2007.