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Individual

MR. JAMES BLAKELY GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MRC

Contact information

Practice address
1821 PICKENS ST, COLUMBIA, SC 29201-2630
(803) 929-1234
(803) 929-1247
Mailing address
1800 COLONIAL DRIVE, COLUMBIA, SC 29203-2219
(803) 898-1555
(803) 898-2194

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
#4691
SC

Other

Enumeration date
04/27/2006
Last updated
07/08/2007
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