Individual
KATISHA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
200 MLK ST, MACON, MS 39341
(662) 726-5042
(662) 726-5009
Mailing address
302 N JACKSON ST, STARKVILLE, MS 39759-2504
(662) 323-9261
(662) 324-9647
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/21/2009
Last updated
08/21/2009
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