RAVEN S GORDON

GARY, IN
NPI1811331796
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: IL  057003528)
Enumeration Date2013-04-23
Last Update Date2013-04-23
Business Address
Ms. RAVEN S GORDON COTA/L
2425 ARTHUR ST #107
GARY, IN 46404-3563
Phone number: 219-902-1498
Mailing Address
Ms. RAVEN S GORDON COTA/L
2425 ARTHUR ST #107
GARY, IN 46404-3563
Phone number: 219-902-1498