Individual
CIMONE LYNAE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6203 OGLETHORPE AVE, PORTAGE, IN 46368-4523
(219) 380-9191
Mailing address
6203 OGLETHORPE AVE, PORTAGE, IN 46368-4523
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IN
Other
Enumeration date
01/12/2026
Last updated
01/12/2026
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