Gordon, Maria Willis
Gordon, Maria Willis is an sole proprietor health care provider with primary practice located at 1930 Fulton Rd Nw Suite 102, Canton OH 44709-3526. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Gordon, Maria Willis can be contacted via phone (330) 430-9535.Contact Information
Primary practice address
1930 Fulton Rd Nw Suite 102
Canton OH 44709-3526
Phone: (330) 430-9535
Fax: (330) 430-9534
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | I5078 | Ohio |
Profile Details
| NPI number | 1902829682 |
|---|---|
| LBN Legal business name | Gordon, Maria Willis |
| Credentials | LISW, LICDC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1902829682 | NPPES |
| Ohio | Other | 00000388720 | ANTHEM BC/BS |
| Ohio | Other | 318639 | ANTHEM BC/BS |
| Ohio | Other | 760801293027 | ANTHEM BC/BS |
| Ohio | Other | 80249800 | ANTHEM BC/BS |
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