Individual
DR. REBECCA JACOBS GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
31 CHERRY ST, SUITE 101, MILFORD, CT 06460-3465
(203) 727-0825
Mailing address
31 CHERRY ST, SUITE 101, MILFORD, CT 06460-3465
(203) 727-0825
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
019720
NY
103T00000X
Psychologist
3283
CT
103TC0700X
Clinical Psychologist
Primary
3283
CT
Other
Enumeration date
09/29/2009
Last updated
10/02/2014
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