Provider Demographics
NPI:1235889353
Name:GORSKI, KAILEY ALEXA
Entity Type:Individual
Prefix:
First Name:KAILEY
Middle Name:ALEXA
Last Name:GORSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 TAYLOR ST UNIT F
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2292
Mailing Address - Country:US
Mailing Address - Phone:978-995-7486
Mailing Address - Fax:
Practice Address - Street 1:350 TAYLOR ST UNIT F
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2292
Practice Address - Country:US
Practice Address - Phone:978-995-7486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program