Jonathan Paul Gorham PSY.D.

NPI 1679754055 - Psychologist - 103TC0700X

NPI Details
NPI 1679754055
Gender Male
Enumeration Date 11/14/2007
Last Updated 05/23/2011
Entity Type Individual
Active Over 9 years ago
Practice Location
697 LOUISIANA DR.
DYESS AFB TX, 79607, US
Phone (325) 696-5380
Fax (352) 696-5579
Business Location
697 LOUISIANA DR.
DYESS AFB TX, 79607, US
Phone (325) 696-5380
Fax (352) 696-5579
Toxanomy
Taxonomy Code 103TC0700X
License State New York
License Number 019063-1
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According to our database, Dr. Jonathan Paul Gorham PSY.D. NPI is 1679754055, taxonomy code is 103TC0700X and license number is 019063-1, license state is located at New York. Jonathan Paul Gorham PSY.D. physically located at 697 Louisiana Dr., Dyess Afb TX, 79607. NPI Number Jonathan Paul Gorham PSY.D. has the Individual type.

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1679754055 NPI number is provided on an as is basis without warranty of any kind. 1679754055 is maintained by the National Plan & Provider Enumeration System. The contents of Jonathan Paul Gorham PSY.D. are for informational purposes only.