Individual
MRS. JAN MARIE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10320 RIDGE LINE CT, INDIANAPOLIS, IN 46236-7738
(317) 823-8984
Mailing address
10320 RIDGE LINE CT, INDIANAPOLIS, IN 46236-7738
(317) 823-8984
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004719A
IN
Other
Enumeration date
01/18/2019
Last updated
01/18/2019
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