Individual
LAUREN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2802 COHO ST STE 203, MADISON, WI 53713-4521
(608) 291-7033
Mailing address
302 GRAND CANYON DR APT 11, MADISON, WI 53705-4263
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/19/2022
Last updated
08/19/2022
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