Provider Demographics
NPI:1467998625
Name:GORHAM, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:GORHAM
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ELIZABETH
Other - Last Name:GRAZIANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3025 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4518
Mailing Address - Country:US
Mailing Address - Phone:717-737-7903
Mailing Address - Fax:717-737-3519
Practice Address - Street 1:3025 MARKET ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4518
Practice Address - Country:US
Practice Address - Phone:717-737-7903
Practice Address - Fax:717-737-3519
Is Sole Proprietor?:No
Enumeration Date:2017-01-12
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC017240225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation