Individual
LANELL GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13827 NW 155TH LN, ALACHUA, FL 32615-5886
(352) 327-8571
Mailing address
13827 NW 155TH LN, ALACHUA, FL 32615-5886
(352) 327-8571
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
10/18/2024
Last updated
10/18/2024
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