Individual
DEBRA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
2555 WEST BLVD, BELLEVILLE, IL 62221-5525
(618) 222-3700
Mailing address
2555 WEST BLVD, BELLEVILLE, IL 62221-5525
(618) 222-3700
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.003962
IL
Other
Enumeration date
12/02/2013
Last updated
12/02/2013
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