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NPI Code Detail

MEDICARE: TIFFANY GORHAM LMFT

MEDICARE:   TIFFANY  GORHAM  LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist124747CA
2106H00000XMarriage & Family Therapist10563OK

General Provider Information

NPI Number : 1881279925
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY GORHAM LMFT
Provider Business Mailing Address
First Line : 820 W DANFORTH RD # 149
Second Line :
City : EDMOND
State : OK
Zip : 73003-5006
Country : US
Telephone Number : 405-994-4457
Fax Number :
Provider Business Practice Location Address
First Line : 820 W DANFORTH RD # 149
Second Line :
City : EDMOND
State : OK
Zip : 73003-5006
Country : US
Telephone Number : 405-994-4457
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2021
Last Update Date : 07/05/2025

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Directions to “ TIFFANY GORHAM LMFT” Practice Location

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