Individual
SHELBY GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBA
Contact information
Practice address
3420 NE EVANGELINE TRWY, LAFAYETTE, LA 70507-2554
(337) 534-8679
(337) 534-0027
Mailing address
3420 NE EVANGELINE TRWY, LAFAYETTE, LA 70507-2554
(337) 534-8679
(337) 534-0027
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-597
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L-597
LBA LICENSE
LA
Enumeration date
01/07/2022
Last updated
01/07/2022
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