Individual
DAIJJAH T GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3610 MYSTIC VALLEY PARKWAY, N1009, MEDFORD, MA 02155-0215
(857) 346-9279
Mailing address
3610 MYSTIC VALLEY PARKWAY, N1009, MEDFORD, MA 02155
(857) 346-9279
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
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