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General NPI Number Information
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NPI Number | 1477851178
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Entity Type | Individual
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Provider Name | BETHANY CATHERINE GORKA MS
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Gender | Female
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 30200 TELEGRAPH RD STE 207
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City | BINGHAM FARMS
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State | MI
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Zip | 48025-5711
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Country | US
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Telephone | 218-712-1129
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Fax | 248-792-3249
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Provider Business Mailing Address
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Address Line | 35640 W MICHIGAN AVE
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City | WAYNE
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State | MI
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Zip | 48184-1628
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Country | US
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Telephone | 734-729-7792
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 7401000297
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License Number State | MI
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