Provider Demographics
NPI:1245580612
Name:GORTER, ERIN (PHD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:GORTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16620 N 40TH ST BLDG I
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-3348
Mailing Address - Country:US
Mailing Address - Phone:480-801-0101
Mailing Address - Fax:602-926-0352
Practice Address - Street 1:16620 N 40TH ST BLDG I
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-3348
Practice Address - Country:US
Practice Address - Phone:480-801-0101
Practice Address - Fax:602-926-0352
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60284262103T00000X
AZPSY-005601103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist