Gordon, Isiasha Mark
Gordon, Isiasha Mark is an individual health care provider with primary practice located at 181 Town Creek Rd , Aiken SC 29803-5841. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Gordon, Isiasha Mark can be contacted via phone (803) 642-0700.Contact Information
Primary practice address
181 Town Creek Rd
Aiken SC 29803-5841
Phone: (803) 642-0700
Fax: (803) 642-0588
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 5862 | South Carolina |
Profile Details
| NPI number | 1174992762 |
|---|---|
| LBN Legal business name | Gordon, Isiasha Mark |
| Credentials | SLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 24th, 2015 |
| Last updated | Aug 24th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174992762 | NPPES |
| South Carolina | Other | 5862 | STATE LICENSE |
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