Individual
ANDREW DERRICK GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
500 LANIER AVE W, FAYETTEVILLE, GA 30214-7636
(404) 800-4002
(404) 393-5698
Mailing address
7097 SOUTHFACE WAY, AUSTELL, GA 30168-6361
(770) 314-7674
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC012296
GA
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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