MR. Mark Anthony George Gagnon JR., LCSW
NPI #1467229401 in Merritt Island, Florida
Provider Information
- NPI Number
- 1467229401
- Entity Type
- Individual
- Name
- MR. Mark Anthony George Gagnon JR., LCSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Mental Health
- Credential
- LCSW
- Enumeration Date
- Dec 11, 2023
- Last Updated
- Apr 18, 2024
Practice Location
- Address
- 240 BONITA DR
- City
- Merritt Island
- State
- Florida
- ZIP Code
- 32952-5102
- Phone
- (321) 355-2157
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
| Counselor - Mental Health — Mental Health |
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