Provider Information for 1952675118
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LAUREN GORDON MS, LPC
Sex: Female
NPI: 1952675118
Last Updated: 2024-04-04
Certification Date: 2024-04-04
Certification Date: 2024-04-04
Details
| Name | Value | ||||||||
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| NPI | 1952675118 | ||||||||
| Enumeration Date | 2012-03-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3125 WRENWOOD CT LOGANVILLE, GA 30052-7863 United States Phone: 404-421-9763 | Fax: | ||||||||
| Primary Practice Address | 3125 WRENWOOD CT LOGANVILLE, GA 30052-7863 United States Phone: 404-421-9763 | Fax: | ||||||||
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