Organization Name: | GORHAM THERAPY SERVICES |
NPI Number: | 1740575992 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TENNILLE JOPLIN (OWNER) |
Mailing Address: | 2506 Lithia Pinecrest Rd Valrico |
State: | FL US |
Postal Code: | 335965036 |
Phone Number: | 8133918398 |
Fax Number: | |
NPI Enumeration Date: | 06/16/2011 |
NPI Last Update Date: | 06/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA7641 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |