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Individual

AUSTIN GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3649 CAPE CENTER DR, FAYETTEVILLE, NC 28304-4457
(910) 484-1711
Mailing address
2919 BREEZEWOOD AVE STE 101, FAYETTEVILLE, NC 28303-5283
(910) 484-1711

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-290252
NC

Other

Enumeration date
08/17/2023
Last updated
08/17/2023
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