Doctor Name: | ELIZABETH S. GILLMORE |
NPI Number: | 1215045414 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | 0717000328 |
Business Practice Address: | 415 S Pollard St Vinton, VA - 241792502 |
Business Phone Number: | 5409771102 |
Business Fax Number: | 5403445343 |
Mailing Address: | 108 Lacey Ln, TROUTVILLE |
State: | VA |
Postal Code: | 241756568 |
Phone Number: | 5409771102 |
Fax Number: | 5403445343 |
NPI Enumeration Date: | 08/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 0717000328 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |