Individual
QUANAZHEA DONYEA GORHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5800 N NEBRASKA AVE, TAMPA, FL 33604-7128
(813) 239-8069
(813) 231-7324
Mailing address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 239-8069
(813) 231-4350
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/06/2020
Last updated
11/02/2023
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