Individual
MRS. SHIRLENE MINETA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1264 EMMA JEAN PL SW, MARIETTA, GA 30064-3798
(770) 912-8894
(770) 573-7316
Mailing address
2500 DALLAS HWY SW STE 202, MARIETTA, GA 30064-7505
(770) 912-8894
(770) 573-7316
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002518
GA
Other
Enumeration date
08/21/2008
Last updated
08/21/2008
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