Provider Demographics
NPI:1194901819
Name:GORMAN, PATRICIA A (EDD)
Entity type:Individual
Prefix:PROF
First Name:PATRICIA
Middle Name:A
Last Name:GORMAN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 CARRIAGE LN
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3338
Mailing Address - Country:US
Mailing Address - Phone:413-253-2243
Mailing Address - Fax:
Practice Address - Street 1:47 CARRIAGE LN
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-3338
Practice Address - Country:US
Practice Address - Phone:413-253-2243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6304103TC0700X
MA766106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical