Organization
GORDON THERAPEUTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SECQUAY GORDON PH.D, LMFT (OWNER)
(754) 444-6032
Entity
Organization
Contact information
Practice address
120 S UNIVERSITY DR STE F, PLANTATION, FL 33324-3346
(754) 444-6032
Mailing address
814 SW 119TH WAY, DAVIE, FL 33325-3890
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT3022
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871948968
—
FL
Enumeration date
03/14/2018
Last updated
03/14/2018
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