Provider Demographics
NPI:1538532734
Name:GORANT, JOANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:GORANT
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 1:1607 ROBINSON RD SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-1741
Mailing Address - Country:US
Mailing Address - Phone:616-632-2899
Mailing Address - Fax:616-732-4548
Practice Address - Street 1:1607 ROBINSON RD SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-1741
Practice Address - Country:US
Practice Address - Phone:616-632-2899
Practice Address - Fax:616-732-4548
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI26010004452255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer