| NPI | 1255683561 |
|---|---|
| Former Name | DEZIRE' MARTINEAY GORDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY28775) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA RA897812) |
| 101YP2500X Counselor, Professional (Licence: IL 178.003764) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: IL 17815) | |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2024-02-21 |