Gordon, Molly
Gordon, Molly is an sole proprietor health care provider with primary practice located at 884 Broadway Ste 5 , South Portland ME 04106-4371. 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, Molly can be contacted via phone (207) 358-0065.Contact Information
Primary practice address
884 Broadway Ste 5
South Portland ME 04106-4371
Phone: (207) 358-0065
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | ||
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | ST2853 | Maine |
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SP2985 | Maine |
Profile Details
| NPI number | 1346723079 |
|---|---|
| LBN Legal business name | Gordon, Molly |
| Credentials | MS, CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 10th, 2018 |
| Last updated | Apr 26th, 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 | 1346723079 | NPPES |
| Maine | MEDICAID | METPID011803 |
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