Individual
MR. GORDON JACK GUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2458 S CAMINO REAL, WASHINGTON, UT 84780-8292
(435) 773-1117
Mailing address
2458 S CAMINO REAL, WASHINGTON, UT 84780-8292
(435) 773-1117
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
121756-3501
UT
Other
Enumeration date
06/12/2007
Last updated
04/25/2008
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