Provider Demographics
NPI:1447819446
Name:GORJON, DONNA
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:GORJON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:GORJON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3901 DENFELD AVE
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-1510
Mailing Address - Country:US
Mailing Address - Phone:240-740-0920
Mailing Address - Fax:
Practice Address - Street 1:3901 DENFELD AVE
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-1510
Practice Address - Country:US
Practice Address - Phone:240-740-0920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
07066235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist