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Individual

CARLY GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
TELEMEDICINE SERVICE, 15 OLIVE AVE, PIEDMONT, CA 94611-4427
(209) 210-8262
Mailing address
15 OLIVE AVE # 11, PIEDMONT, CA 94611-4427
(209) 210-8262

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-1478
HI

Other

Enumeration date
07/06/2015
Last updated
11/17/2020
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