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Individual
SARAH JOAN GORDON
Active
Individual
SARAH JOAN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.I.C.S.W
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
19093
MN
103K00000X
Behavior Analyst
19093
MN
1041C0700X
Clinical Social Worker
19093
MN
1041C0700X
Clinical Social Worker
Primary
7156
OR
Other
Enumeration date
09/26/2012
Last updated
02/09/2017
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