Individual
LEIFA ROSE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
75 BECKETT ST, APT 2, PORTLAND, ME 04101-4402
(207) 491-4951
Mailing address
75 BECKETT ST, APT 2, PORTLAND, ME 04101-4402
(207) 491-4951
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC16156
ME
Other
Enumeration date
08/10/2016
Last updated
08/10/2016
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