Individual
JUDITH L GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3288 E PINE AVE, MERIDIAN, ID 83642-5922
(208) 888-8887
(208) 658-0153
Mailing address
11898 W GOLDENROD AVE, BOISE, ID 83713-2439
(208) 658-9703
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178
ID
101YS0200X
School Counselor
178
ID
Other
Enumeration date
04/26/2013
Last updated
04/26/2013
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