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Individual

MR. LESLIE MICHAEL GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
7432 WILES RD, CORAL SPRINGS, FL 33067-2066
(954) 227-4492
(954) 227-4493
Mailing address
7432 WILES RD, CORAL SPRINGS, FL 33067-2066
(954) 227-4492
(954) 227-4493

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT0001117
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Z2501
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/28/2009
Last updated
05/28/2009
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