Doctor Name: | COLLEEN M. GORDON |
NPI Number: | 1306978028 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | SA5073 |
Business Practice Address: | 3950 3rd St N Suite D Saint Petersburg, FL - 337036123 |
Business Phone Number: | 7278968086 |
Business Fax Number: | 7278961017 |
Mailing Address: | 3950 3rd St N, Suite D SAINT PETERSBURG |
State: | FL |
Postal Code: | 337036123 |
Phone Number: | 7278968086 |
Fax Number: | 7278961017 |
NPI Enumeration Date: | 03/09/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA5073 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |