Individual
MOLLY GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
854 BROADWAY STE 2, SOUTH PORTLAND, ME 04106-2712
(207) 358-0065
(207) 387-1904
Mailing address
854 BROADWAY STE 2, SOUTH PORTLAND, ME 04106-2712
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP2985
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
METPID011803
—
ME
Enumeration date
09/10/2018
Last updated
05/01/2025
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