Individual
TAWANA LAVETTE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8242 DURALEE LN APT 909, DOUGLASVILLE, GA 30134-8507
(770) 324-6799
Mailing address
8242 DURALEE LN APT 909, DOUGLASVILLE, GA 30134-8507
(770) 324-6799
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/16/2020
Last updated
06/16/2020
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