Gordon, Athena Boolukos

Gordon, Athena Boolukos is an individual health care provider with primary practice located at 4201 Bayshore Blvd Unit 1603, Tampa FL 33611-1669. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Adult Development & Aging. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Gordon, Athena Boolukos can be contacted via phone (617) 784-0771.

Contact Information

Primary practice address
4201 Bayshore Blvd Unit 1603 Tampa FL 33611-1669
Phone: (617) 784-0771
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PY8510 Florida
Behavioral Health & Social Service Providers / Adult Development & Aging 103TA0700X PY8510 Florida

Profile Details

NPI number 1700146552
LBN Legal business name Gordon, Athena Boolukos
Credentials EDM, PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2012
Last updated May 25th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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