Gordon, Stacy Lynn

Gordon, Stacy Lynn is an individual health care provider with primary practice located at 2981 Kanell Blvd , Poplar Bluff MO 63901-4008. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Gordon, Stacy Lynn can be contacted via phone (573) 712-2902.

Contact Information

Primary practice address
2981 Kanell Blvd Poplar Bluff MO 63901-4008
Phone: (573) 712-2902
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1740821792
LBN Legal business name Gordon, Stacy Lynn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 1st, 2019
Last updated Oct 1st, 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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