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Individual

MISS SAMANTHA GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., LMFT

Contact information

Practice address
2140 E SOUTHLAKE BLVD STE L-636, SOUTHLAKE, TX 76092-6516
(817) 303-9374
Mailing address
2140 E SOUTHLAKE BLVD STE L-636, SOUTHLAKE, TX 76092-6516
(954) 249-2117

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
203759
TX

Other

Enumeration date
03/12/2021
Last updated
11/02/2022
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