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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 17 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 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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