| NPI | 1104384098 |
|---|---|
| Other Name | ELLIE GORDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2022012232) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: MO 2022012232) |
| Enumeration Date | 2019-03-09 |
| Last Update Date | 2022-09-21 |