Daijjah T Gordon
Behavior Technician in Medford, Massachusetts
1285490425- Practice location
- 3610 Mystic Valley Parkway, N1009, Medford, MA 02155-0215
- Phone
- 857-346-9279
- Fax
- —
- Last updated
- February 26, 2024
Daijjah T Gordon is a Behavior Technician based in Medford, MA. Daijjah T Gordon practices in Medford, MA. The NPI Number for Daijjah T Gordon is 1285490425. The current practice location address for Daijjah T Gordon is 3610 Mystic Valley Parkway, N1009, Medford, MA 02155-0215 and can be reached out via phone at 857-346-9279.
Provider Profile Details
- NPI Number
- 1285490425
- Provider Name
- Daijjah T Gordon
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 3610 Mystic Valley Parkway, N1009, Medford, MA 02155-0215
- Phone Number
- 857-346-9279
- Primary Taxonomy
- Behavior Technician · 106S00000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- February 26, 2024
- Last Update Date
- February 26, 2024
- Certification Date
- February 26, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 3610 Mystic Valley Parkway
N1009
Medford, MA 02155-0215 - City
- Medford
- State
- Massachusetts
- Zip
- 02155-0215
- Phone Number
- 857-346-9279
Provider Business Mailing Address Details
- Address
- 3610 Mystic Valley Parkway
N1009
Medford, MA 02155 - City
- Medford
- State
- MA
- Zip
- 02155
- Phone Number
- 857-346-9279
License Information
- Taxonomy (1)
- Behavior Technician · 106S00000X
- License State (2)
- MA
- Taxonomy (2)
- Behavior Technician · 106S00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Daijjah T Gordon?
The NPI number of Daijjah T Gordon is 1285490425. It was assigned on February 26, 2024 and is currently active in the NPPES registry.
What is the specialty of Daijjah T Gordon?
Daijjah T Gordon is registered under the primary taxonomy Behavior Technician (code 106S00000X).
Where does Daijjah T Gordon practice?
The practice location is 3610 Mystic Valley Parkway, N1009, Medford, MA 02155-0215. The office can be reached at 857-346-9279 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1285490425 directly on the NPPES registry website.