Individual
GEORGINA LYNN MORDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
62 PROVIDENCE PIKE, PUTNAM, CT 06260-2412
(818) 241-6780
Mailing address
1055 E COLORADO BLVD STE 560, PASADENA, CA 91106-2380
(818) 241-6780
(818) 241-6853
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/17/2020
Last updated
02/17/2020
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