Organization Name: | GORDER CONSULTING, PLLC |
NPI Number: | 1225448798 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | COREY J GORDER (OWNER) |
Mailing Address: | 104 11th St W Ste 4 Bottineau |
State: | ND US |
Postal Code: | 583182005 |
Phone Number: | 7012010076 |
Fax Number: | |
NPI Enumeration Date: | 05/05/2014 |
NPI Last Update Date: | 05/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 569121506190 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ND |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |