Rachel A Gordon, LCSW
Social Worker, Clinical in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1801192570
StatusActive
Last updated in NPPESMar 21, 2013
Details
- NPI
- 1801192570
- Entity type
- Individual (NPI-1)
- Name
- Rachel A Gordon
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 28, 2011
- Last updated
- Mar 21, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 34006166A | IN | Yes |
Practice location
2121 Lake AveFort Wayne, IN 46805-5100
Phone 260-426-5431
Mailing address
2121 Lake AveFort Wayne, IN 46805-5100
Phone 260-426-5431
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