| NPI | 1336490382 |
|---|---|
| Other Name | RACHELLE THEISE GORDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 019812-1) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 019812-1) |
| Enumeration Date | 2012-09-29 |
| Last Update Date | 2013-02-07 |