KENRIC GORDON, LMSW

Social Worker

Active Individual
NPI: 1114540804

Practice Address

210 W BURNSIDE AVE STE A
Chubbuck, ID 83202

Phone: (208) 238-9000

Specialties

Specialty Code Primary License
Social Worker 104100000X Yes LMSW-39661 (ID)

Frequently Asked Questions

NPI 1114540804 is the National Provider Identifier for KENRIC GORDON, LMSW, a Social Worker provider located in Chubbuck, ID. This NPI was enumerated on May 28, 2020.
KENRIC GORDON, LMSW practices at 210 W BURNSIDE AVE STE A, Chubbuck, ID 83202.

Quick Facts

NPI
1114540804
Type
Individual
Enumerated
May 28, 2020
Last Updated
May 28, 2020

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