Individual
DR. JACLYN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
42 ILLINOIS AVE, LONG BEACH, NY 11561-1112
(347) 559-5694
Mailing address
42 ILLINOIS AVE, LONG BEACH, NY 11561-1112
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
026039
NY
Other
Enumeration date
04/08/2024
Last updated
01/20/2025
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