Individual
MRS. BRIDGET MOSS GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
13260 N 94TH DR, SUITE 104, PEORIA, AZ 85381-4828
(623) 974-8900
(623) 974-8911
Mailing address
11722 WEST MARIPOSA GRANDE, SUN CITY, AZ 85373
(623) 444-5207
(623) 974-8911
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15928
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0913750
BLUE CROSS BLUE SHIELD AZ
AZ
Enumeration date
01/29/2007
Last updated
12/17/2007
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