Individual
MR. DAVID PAUL GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
133 W 50TH ST, MINNEAPOLIS, MN 55419-1307
(612) 281-7773
Mailing address
133 W 50TH ST, MINNEAPOLIS, MN 55419-1307
(612) 281-7773
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
45-0463081
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45-0463081
EMPLOYEE ID NUMBER
MN
Enumeration date
04/27/2007
Last updated
02/20/2024
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