Individual
CARIE JO THOMSEN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, IADC
Contact information
Practice address
3601 16TH AVE SW, CEDAR RAPIDS, IA 52404-2328
(319) 390-4611
Mailing address
3601 16TH AVE SW, CEDAR RAPIDS, IA 52404-2328
(319) 390-4611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
95178
IA
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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