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General NPI Number Information
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NPI Number | 1578789038
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Entity Type | Individual
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Provider Name | SHARON KIRKLAND-GORDON PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 1207 DELAWARE AVE STE 103
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City | BUFFALO
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State | NY
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Zip | 14209-1459
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Country | US
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Telephone | 716-248-8295
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Fax | 855-932-2003
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Provider Business Mailing Address
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Address Line | 352 PRATT ST
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City | BUFFALO
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State | NY
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Zip | 14204-1564
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Country | US
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Telephone | 716-248-8295
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Fax | 855-932-2003
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 03093
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License Number State | MD
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