Most Relevant Information
Provider Data
| NPI Number: | 1003296062 |
| Provider Name: | SHAINA GORDON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | CSW005234 |
Most Important Dates
| Enumeration Date: | 06/04/2015 |
| Last Updated: | 02/18/2017 |
Provider Practice Location
465 WINN WAY
221
DECATUR
GA
300301753
Practice Location Phone/Fax
| Phone: | 4042923810 |
| Fax: |
Provider Mailing Location
980 SAINT CHARLES AVE NE
#3
ATLANTA
GA
303064263
Provider Mailing Phone/Fax
| Phone: | 9548951453 |
| Fax: |