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Organization
MOLLY GORDON, SLP, LLC
Active
Organization
MOLLY GORDON, SLP, LLC
Active
Other names
Molly Gordon, SLP
Organization subpart
No
Provider details
NPI number
Authorized official
MOLLY GORDON MS, CCC-SLP (OWNER)
(207) 358-0065
Entity
Organization
Contact information
Practice address
884 BROADWAY UNIT 5, SOUTH PORTLAND, ME 04106-4371
(207) 358-0065
Mailing address
884 BROADWAY STE 5, SOUTH PORTLAND, ME 04106-4371
(207) 358-0065
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
METPID011803
—
ME
Enumeration date
10/25/2021
Last updated
01/30/2023
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