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1275729881
SUSAN THERESA GORDON
FARGO, ND
NPI
1275729881
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: MN 301445)
Enumeration Date
2007-09-18
Last Update Date
2007-09-18
Business Address
SUSAN THERESA GORDON LADC
4227 9TH AVE SW
FARGO, ND 58103-2018
Phone number: 701-282-6561
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Mailing Address
SUSAN THERESA GORDON LADC
715 11TH ST N
MOORHEAD, MN 56560-2083
Phone number: 218-233-6398
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