Individual
LACEY GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3929 ROCKY RIVER DR, CLEVELAND, OH 44111-4153
(216) 252-5800
Mailing address
3929 ROCKY RIVER DR, CLEVELAND, OH 44111-4153
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
02/12/2018
Last updated
02/12/2018
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