Individual
MR. GORDON LANCE MUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
675 TOWN SQUARE BLVD, SUITE 200, BUILDING 1A, GARLAND, TX 75040
(214) 804-9262
(972) 495-1863
Mailing address
675 TOWN SQUARE BLVD., SUITE 200, BUILDING 1A, GARLAND, TX 75040
(214) 804-9262
(972) 495-1863
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
22687
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064284501
—
TX
Enumeration date
07/26/2005
Last updated
06/24/2014
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