Individual
ALICIA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
132 CAROL CIR, FITZGERALD, GA 31750-8128
(561) 252-7261
Mailing address
5464 CLUB CIR, HAVERHILL, FL 33415-1262
(561) 252-7261
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
FL
Other
Enumeration date
12/04/2017
Last updated
11/09/2020
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