Callista Gordon Therapy, Llc | |
53846 Generations Dr South Bend IN 46635-1543 | |
(574) 701-2799 | |
Not Available |
Full Name | Callista Gordon Therapy, Llc |
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Speciality | Social Worker - Clinical |
Location | 53846 Generations Dr, South Bend, Indiana |
Authorized Official Name and Position | Callista Gordon (OWNER) |
Authorized Official Contact | 5742204701 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Callista Gordon Therapy, Llc 503 Downey Ave Mishawaka IN 46544-3455 Ph: (574) 220-4701 | Callista Gordon Therapy, Llc 53846 Generations Dr South Bend IN 46635-1543 Ph: (574) 701-2799 |
NPI Number | 1932933884 |
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Provider Enumeration Date | 08/30/2024 |
Last Update Date | 08/30/2024 |
Certification Date | 08/30/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932933884 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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