| Doctor Name: | MRS. JESSICA SUE GORDON |
| NPI Number: | 1255580692 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | AT |
| License Number: | |
| Business Practice Address: | 417 W Main St Suite B Trumann, AR - 724723116 |
| Business Phone Number: | 8704837039 |
| Business Fax Number: | 8704830590 |
| Mailing Address: | 5537 Bleaux Ave, SPRINGDALE |
| State: | AR |
| Postal Code: | 727620737 |
| Phone Number: | 4798725580 |
| Fax Number: | 4798725581 |
| NPI Enumeration Date: | 09/10/2008 |
| NPI Last Update Date: | 09/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |