Doctor Name: | MS. SHIRLEY ANN GOLLADAY |
NPI Number: | 1003110289 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MHS, CADC |
License Number: | 26382 |
Business Practice Address: | 20303 Crawford Ave Suite 100 Olympia Fields, IL - 604611073 |
Business Phone Number: | 7087479399 |
Business Fax Number: | 7087471908 |
Mailing Address: | 20303 Crawford Ave, Suite 100 OLYMPIA FIELDS |
State: | IL |
Postal Code: | 604611073 |
Phone Number: | 7087479399 |
Fax Number: | 7087471908 |
NPI Enumeration Date: | 01/03/2011 |
NPI Last Update Date: | 01/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 26382 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |