| Doctor Name: | MS. SHALANDA NICHELLE GORDON |
| NPI Number: | 1649500463 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 34687 |
| Business Practice Address: | 8632 Fredericksburg Road Suite 218 San Antonio, TX - 78240 |
| Business Phone Number: | 2102020606 |
| Business Fax Number: | 8448954585 |
| Mailing Address: | 8632 Fredericksburg Road, Suite 218 SAN ANTONIO |
| State: | TX |
| Postal Code: | 78240 |
| Phone Number: | 2102020606 |
| Fax Number: | 8448954585 |
| NPI Enumeration Date: | 12/29/2009 |
| NPI Last Update Date: | 04/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103G00000X |
| License Number: | 34687 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Clinical Neuropsychologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |