Individual
SHAINA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
465 WINN WAY, 221, DECATUR, GA 30030-1753
(404) 292-3810
Mailing address
980 SAINT CHARLES AVE NE, #3, ATLANTA, GA 30306-4263
(954) 895-1453
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CSW005234
GA
Other
Enumeration date
06/04/2015
Last updated
02/18/2017
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