Individual
STEPHEN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1221 PROVIDENCE LN, LEXINGTON, KY 40502-2380
(540) 219-9672
Mailing address
1221 PROVIDENCE LN, LEXINGTON, KY 40502-2380
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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