Mr. COLT GORDON LCSW 110973
Individual Provider (NPI-1)
Active
Social Worker, Clinical
Provider Information
- NPI Number
1538762471- Provider Type
- Individual Provider (NPI-1)
- Credentials
- LCSW 110973
- Status
- Active
Contact & Location
- Address
- 627 15TH ST, CODY, WY, 824143109
- Phone
- (619) 453-5063
Specialties & Taxonomies
Social Worker, Clinical
License: WY #1577
Social Worker, Clinical
Primary License: CA #110973