Individual
EMILY GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
703 REGESTER AVE, BALTIMORE, MD 21212-1919
(443) 632-8426
Mailing address
703 REGESTER AVE, BALTIMORE, MD 21212-1919
(443) 632-8426
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20997
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
887155800
—
MD
Enumeration date
04/21/2017
Last updated
03/30/2022
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