Individual
JERRY GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, M.ED
Contact information
Practice address
8500 N STEMMONS FWY, SUITE#4015-H, DALLAS, TX 75247-3832
(214) 882-2269
Mailing address
8500 N STEMMONS FWY, SUITE#4015-H, DALLAS, TX 75247-3832
(214) 882-2269
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
770
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
095286302
—
TX
Enumeration date
05/16/2008
Last updated
05/16/2008
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