Organization
GORHAM THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TENNILLE JOPLIN (ADMINISTRATOR)
(813) 391-8398
Entity
Organization
Contact information
Practice address
3433 LITHIA PINECREST RD STE 135, VALRICO, FL 33596-6302
(813) 391-8398
Mailing address
3433 LITHIA PINECREST RD STE 135, VALRICO, FL 33596-6302
(813) 391-8398
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SZ6914
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SZ6914
LICENSE
FL
Enumeration date
05/02/2016
Last updated
05/02/2016
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