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General NPI Number Information
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NPI Number | 1760122972
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Entity Type | Organization
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Legal Business Name | GORHAM PSYCHOTHERAPY PC DBA TOWNSEND THERAPY SERVICES
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Dates
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Enumeration Date | 03/29/2022
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 820 W DANFORTH RD
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City | EDMOND
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State | OK
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Zip | 73003-5006
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Country | US
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Telephone | 405-930-3389
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Fax | 405-930-3398
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Provider Business Mailing Address
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Address Line | 820 W DANFORTH RD
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City | EDMOND
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State | OK
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Zip | 73003-5006
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Country | US
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Telephone | 405-930-3389
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Fax | 405-930-3398
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY GORHAM
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Credential |
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Telephone | 209-840-2303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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