Gordon, Michael Deshuan

Gordon, Michael Deshuan is an sole proprietor health care provider with primary practice located at 112 Spanish Moss Dr , Clinton MS 39056-5838. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Gordon, Michael Deshuan can be contacted via phone (601) 376-6222.

Contact Information

Primary practice address
112 Spanish Moss Dr Clinton MS 39056-5838
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2272 Mississippi

Profile Details

NPI number 1871136267
LBN Legal business name Gordon, Michael Deshuan
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 18th, 2019
Last updated Oct 18th, 2019 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1871136267 NPPES
Mississippi Other NONE NONE

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