Individual
LAURA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
150 DERBY ST, ATHENS, GA 30601-3318
(762) 499-4362
Mailing address
150 DERBY ST, ATHENS, GA 30601-3318
(762) 499-4362
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW007497
GA
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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