| Doctor Name: | MS. JILLIAN ELIZABETH GISMONDI |
| NPI Number: | 1013162056 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA LPC NCC |
| License Number: | 6401009663 |
| Business Practice Address: | 15370 Levan Rd Ste 2 Livonia, MI - 481541903 |
| Business Phone Number: | 7347440170 |
| Business Fax Number: | 7347440171 |
| Mailing Address: | 15370 Levan Rd Ste 2, LIVONIA |
| State: | MI |
| Postal Code: | 481541903 |
| Phone Number: | 7347440170 |
| Fax Number: | 7347440171 |
| NPI Enumeration Date: | 11/18/2008 |
| NPI Last Update Date: | 11/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401009663 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |