Individual
AVIVA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2410 GRAPE RD STE 6, MISHAWAKA, IN 46545-3015
(419) 695-8010
(419) 932-6232
Mailing address
10100 ELIDA RD, DELPHOS, OH 45833-9058
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
IN
Other
Enumeration date
02/09/2017
Last updated
09/30/2025
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