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Individual
KIRSTIE GORGAS
Active
Individual
KIRSTIE GORGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225X00000X
Occupational Therapist
Primary
026591
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659525582
UPSTATE CEREBRAL PALSY
NY
Enumeration date
06/15/2015
Last updated
03/04/2022
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