Gordon, Todd Kenneth

Gordon, Todd Kenneth is an sole proprietor health care provider with primary practice located at 3-3212 Kuhio Hwy , Lihue HI 96766-1142. He recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as his primary health care specialty. Gordon, Todd Kenneth can be contacted via phone (808) 274-3190.

Contact Information

Primary practice address
3-3212 Kuhio Hwy Lihue HI 96766-1142
Fax: (808) 274-3194
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X

Profile Details

NPI number 1477685030
LBN Legal business name Gordon, Todd Kenneth
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 9th, 2007
Last updated Jul 9th, 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 1477685030 NPPES
Hawaii MEDICAID 539372-01

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