Individual
MS. KATHLEEN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1010 E 10TH ST, TUCSON, AZ 85719-5813
(520) 661-6235
Mailing address
1010 E 10TH ST, TUCSON, AZ 85719-5813
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-0751
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
628422
—
AZ
Enumeration date
03/15/2007
Last updated
07/09/2007
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