Individual
DENNETT HOWE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
111 GREEN VIEW RD SW, ROME, GA 30165-4305
(706) 235-1400
(706) 510-1357
Mailing address
PO BOX 5072, ROME, GA 30162-5072
(706) 235-1400
(706) 378-8840
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY003017
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108296834B
—
GA
Enumeration date
10/06/2006
Last updated
01/18/2022
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