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Raven Gordon, COTA/L
NPI 1811331796 · on the registry since 2013 · sole proprietor
Practice
- Address
- 2425 Arthur St
#107
Gary, IN 46404 - Phone
- (219) 902-1498
Registry record
- Primary taxonomy
- 224Z00000X
224Z00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2013-04-23
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana