Most Relevant Information
Provider Data
| NPI Number: | 1003001355 |
| Provider Name: | KRISTIN GORNING MA DT |
| Entity Type: | Individual |
| Taxonomy Code: | 222Q00000X |
| Specialty: | Developmental Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/10/2007 |
| Last Updated: | 09/10/2007 |
Provider Practice Location
715 W ARMITAGE AVE # 2
CHICAGO
IL
606144409
Practice Location Phone/Fax
| Phone: | 7734580951 |
| Fax: |
Provider Mailing Location
715 W ARMITAGE AVE # 2
CHICAGO
IL
606144409
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |