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Individual

MR. GARY LEE GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
6800 BACKLICK RD, SUITE 202, SPRINGFIELD, VA 22150-3070
(703) 921-0692
(703) 921-0692
Mailing address
6551 LOISDALE COURT, SUITE 155, SPRINGFIELD, VA 22150-1808
(703) 921-0692
(703) 921-0637

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003552
VA

Other

Enumeration date
03/06/2007
Last updated
06/02/2009
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