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1699347112
ANDREW DERRICK GORDON
FAYETTEVILLE, GA
NPI
1699347112
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: GA LPC012296)
Enumeration Date
2021-07-14
Last Update Date
2021-07-14
Business Address
ANDREW DERRICK GORDON LPC
500 LANIER AVE W
FAYETTEVILLE, GA 30214-7636
Phone number: 404-800-4002
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Mailing Address
ANDREW DERRICK GORDON LPC
7097 SOUTHFACE WAY
AUSTELL, GA 30168-6361
Phone number: 770-314-7674
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