Organization
GORHAM THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TENNILLE JOPLIN (OWNER)
(813) 391-8398
Entity
Organization
Contact information
Practice address
2506 LITHIA PINECREST RD, VALRICO, FL 33596-5036
(813) 391-8398
Mailing address
2506 LITHIA PINECREST RD, VALRICO, FL 33596-5036
(813) 391-8398
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA7641
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
889910000
—
FL
Enumeration date
06/16/2011
Last updated
06/16/2011
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