| Doctor Name: | MS. SIMONE ROBIN GILLIS |
| NPI Number: | 1427329432 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSMHC |
| License Number: | |
| Business Practice Address: | 800 Macdade Blvd Collingdale, PA - 190233826 |
| Business Phone Number: | 6109389381 |
| Business Fax Number: | |
| Mailing Address: | 1 Old Fence Ln, NEWARK |
| State: | DE |
| Postal Code: | 197023720 |
| Phone Number: | 6109389381 |
| Fax Number: | 6109575406 |
| NPI Enumeration Date: | 01/23/2012 |
| NPI Last Update Date: | 01/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |