Individual
VANESSA D GORHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5335 N TACOMA AVE STE 13, INDIANAPOLIS, IN 46220-3648
(317) 360-2421
Mailing address
11653 STOEPPELWERTH DR, INDIANAPOLIS, IN 46229-4244
(317) 360-2421
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
24-016822-1
IN
Other
Enumeration date
05/31/2024
Last updated
05/31/2024
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