Individual
STACEY MICHELLE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2960 POST RD STE 3B2, SOUTHPORT, CT 06890-1268
(203) 307-3030
Mailing address
15 CLEARVIEW DR, SANDY HOOK, CT 06482-1333
(203) 994-7858
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2949
CT
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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