Individual
ALAN R. GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW. PH.D.
Contact information
Practice address
797 BEAVER CREEK LN, HAVANA, FL 32333-4731
(850) 539-4053
Mailing address
797 BEAVER CREEK LN, HAVANA, FL 32333-4731
(850) 539-4053
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW 1967
FL
Other
Enumeration date
12/07/2006
Last updated
12/28/2011
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