| NPI | 1255429445 |
|---|---|
| Former Name | MELISSA RAE GORDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 13672) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C010020) |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904008672) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2016-11-30 |