Doctor Name: | MARY GLORIA GILLESPIE |
NPI Number: | 1548663636 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | L2408634 |
Business Practice Address: | 303 Ridgeway St Saint Joseph, MI - 490851048 |
Business Phone Number: | 2699835285 |
Business Fax Number: | 2699833531 |
Mailing Address: | 303 Ridgeway St, SAINT JOSEPH |
State: | MI |
Postal Code: | 490851048 |
Phone Number: | 2699835285 |
Fax Number: | 2699833531 |
NPI Enumeration Date: | 10/02/2014 |
NPI Last Update Date: | 10/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | L2408634 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
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 |