Individual
GORDON PAUL GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
650 E 4500 S STE 300, MURRAY, UT 84107-4502
(801) 261-3500
Mailing address
7052 LOCH NESS AVE, SALT LAKE CITY, UT 84128-2323
(801) 718-0158
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
UT
Other
Enumeration date
12/23/2011
Last updated
02/03/2023
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