Individual
MITCHELL MAURICE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPSS, YPSS
Contact information
Practice address
930 SPARKS ST N, TWIN FALLS, ID 83301-3688
(385) 244-9707
Mailing address
930 SPARKS ST N, TWIN FALLS, ID 83301-3688
(385) 244-9707
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/21/2026
Last updated
01/21/2026
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