Individual
NIKETA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4140 OLD WASHINGTON RD, WALDORF, MD 20602-3221
(301) 645-2813
(301) 645-9317
Mailing address
4140 OLD WASHINGTON RD, WALDORF, MD 20602-3221
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01028L
MD
Other
Enumeration date
09/18/2014
Last updated
09/23/2014
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