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Individual
JEFFREY ANDREW GORDON
Active
Individual
JEFFREY ANDREW GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
100373
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/10/2018
Last updated
05/14/2024
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