Individual
DR. DAVID WAYNE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1611 COLLEY AVE STE D, NORFOLK, VA 23517-1677
(757) 288-9741
(757) 625-2563
Mailing address
1611 COLLEY AVE STE D, NORFOLK, VA 23517-1677
(757) 288-9741
(757) 622-3944
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810000716
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00707452
—
VA
Enumeration date
08/09/2006
Last updated
07/08/2007
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