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Organization
INDIVIDUAL EXPRESSIONS THERAPY, LLC
Active
Organization
INDIVIDUAL EXPRESSIONS THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NILKA GORDON M.S., CCC-SLP (OWNER/SPEECH PATHOLOGIST)
(770) 731-8772
Entity
Organization
Contact information
Practice address
8329 OFFICE PARK DR STE A, DOUGLASVILLE, GA 30134-6937
(770) 731-8772
(470) 300-0042
Mailing address
8329 OFFICE PARK DR STE A, DOUGLASVILLE, GA 30134-6937
(770) 731-8772
(470) 300-0042
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003147217D
—
GA
Enumeration date
09/12/2017
Last updated
03/07/2025
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