Organization
PEDIATRIC THERAPY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY B GORIN CCC, SLP (OWNER)
(502) 797-1371
Entity
Organization
Contact information
Practice address
2001 LONG KNIFE CT, LOUISVILLE, KY 40207-1176
(502) 797-1371
(502) 721-6132
Mailing address
2001 LONG KNIFE CT, LOUISVILLE, KY 40207-1176
(502) 797-1371
(502) 721-6132
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22001261A
IN
Other
Enumeration date
04/02/2007
Last updated
06/20/2008
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