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Individual

CALLISTA ANN GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1001 N HICKORY RD, SOUTH BEND, IN 46615-3702
(574) 314-5987
Mailing address
503 DOWNEY AVE, MISHAWAKA, IN 46544-3455
(574) 220-4701

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
08/26/2021
Last updated
08/26/2021
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