GORDON LANE FAISON

BRATTLEBORO, VT
NPI1710192935
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103TP2701X Psychologist, Group Psychotherapy
(Licence: VT  068-0000321)
Enumeration Date2007-05-11
Last Update Date2007-07-08
Business Address
Mr. GORDON LANE FAISON NA LCMHC
54 HARRIS PLACE
BRATTLEBORO, VT 05301
Phone number: 802-380-0695
Mailing Address
Mr. GORDON LANE FAISON NA LCMHC
PO BOX 6262
BRATTLEBORO, VT 05302
Phone number: 802-380-0695