Individual
RAYMOND MARTIN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
22 FRONT ST, FALL RIVER, MA 02721-4302
(508) 676-1307
(508) 674-4493
Mailing address
22 FRONT ST, FALL RIVER, MA 02721-4302
(508) 676-1307
(508) 674-4493
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205054049
—
MA
Enumeration date
10/16/2018
Last updated
10/16/2018
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