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1730690835
DERRICK M GORDON
NEW HAVEN, CT
NPI
1730690835
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: CT 003297)
Enumeration Date
2017-10-16
Last Update Date
2017-10-16
Business Address
DERRICK M GORDON Ph.D.
389 WHITNEY AVE
NEW HAVEN, CT 06511-2301
Phone number: 203-789-7645
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Mailing Address
DERRICK M GORDON Ph.D.
44 OLD QUARRY RD
WOODBRIDGE, CT 06525-1006
Phone number: 203-675-4228
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