Individual
DR. MICHAEL DESHUAN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
112 SPANISH MOSS DR, CLINTON, MS 39056-5838
(601) 376-6222
Mailing address
112 SPANISH MOSS DR, CLINTON, MS 39056-5838
(601) 376-6222
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2272
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
MS
Enumeration date
10/18/2019
Last updated
10/18/2019
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