Individual
DR. MARIE K CHEOUR GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, PSYCHOLOGIST
Contact information
Practice address
8105 NW 111TH TER, PARKLAND, FL 33076-4730
(561) 345-9931
Mailing address
8105 NW 111TH TER, PARKLAND, FL 33076-4730
(561) 345-9931
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
PY 9641
FL
103T00000X
Psychologist
Primary
PY 9641
FL
103TB0200X
Cognitive & Behavioral Psychologist
PY 9641
FL
103TC0700X
Clinical Psychologist
PY 9641
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY 9641
FL
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PY 9641
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019810000
—
FL
Enumeration date
09/03/2016
Last updated
04/15/2019
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