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Individual

DR. JULIAN M GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
9605 GRAND RIVER AVE, DETROIT, MI 48204-2139
(313) 834-5930
Mailing address
53 WILLOW WAY, WATERFORD, MI 48328-2947
(248) 881-2060

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
103T00000X
Psychologist
6301005530
MI

Other

Enumeration date
05/05/2011
Last updated
11/30/2012
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