| NPI | 1235656729 |
|---|---|
| Doing Business As | JUSTIN GORDON, LMFT |
| Entity Type | Organization |
| Authorized Contact | JUSTIN GORDON Therpist/Owner 435-215-3184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: UT 8017789-3902) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2017-08-24 |