Individual
MISS MIMS GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
89 RESERVOIR, NORRIS, TN 37828-0567
(865) 548-7474
Mailing address
PO BOX 567, NORRIS, TN 37828-0567
(865) 548-7474
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
298
TN
101YP2500X
Professional Counselor
298
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4026195
BC/BS
TN
Enumeration date
06/19/2006
Last updated
09/11/2025
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