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Individual

INDIA GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9158 RHETT LN SW, COVINGTON, GA 30014-2081
(706) 819-3089
Mailing address
9158 RHETT LN SW, COVINGTON, GA 30014-2081
(706) 819-3089

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
12/18/2024
Last updated
12/18/2024
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