Individual
ASHLEY GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
625 W DIVISION ST UNIT 613, CHICAGO, IL 60610-2596
(312) 340-9313
Mailing address
625 W DIVISION ST UNIT 613, CHICAGO, IL 60610-2596
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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