Doctor Name: | MS. JUDY ELLEN GORDON |
NPI Number: | 1013006410 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.H.C. |
License Number: | 000294 |
Business Practice Address: | 5006 Dorsey Hall Dr C-2 Ellicott City, MD - 210427737 |
Business Phone Number: | 4436042741 |
Business Fax Number: | |
Mailing Address: | 5006 Dorsey Hall Dr, C-2 ELLICOTT CITY |
State: | MD |
Postal Code: | 210427737 |
Phone Number: | 4436042741 |
Fax Number: | |
NPI Enumeration Date: | 10/12/2006 |
NPI Last Update Date: | 05/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 000294 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |