Dianne M Gordon, LICSW
NPI #1154544096 in Coon Rapids, Minnesota
Provider Information
- NPI Number
- 1154544096
- Entity Type
- Individual
- Name
- Dianne M Gordon, LICSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Credential
- LICSW
- Enumeration Date
- Apr 10, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 11427 HANSON BLVD NW
- City
- Coon Rapids
- State
- Minnesota
- ZIP Code
- 55433-3719
- Phone
- (763) 754-1531
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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