Individual
BRIAN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1060 GAFFNEY RD STOP 7440, FT WAINWRIGHT, AK 99703-5007
(907) 361-5418
Mailing address
1060 GAFFNEY RD STOP 7440, FT WAINWRIGHT, AK 99703-5007
(907) 361-5603
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
23380
CA
Other
Enumeration date
04/27/2012
Last updated
12/27/2012
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