Provider Demographics
NPI:1902021751
Name:VOORHIES, GIGI MGEORGIANNE (CTRS)
Entity Type:Individual
Prefix:MRS
First Name:GIGI
Middle Name:MGEORGIANNE
Last Name:VOORHIES
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-1781
Mailing Address - Country:US
Mailing Address - Phone:812-323-2496
Mailing Address - Fax:
Practice Address - Street 1:410 S WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-1781
Practice Address - Country:US
Practice Address - Phone:812-323-2496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN47870225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist