Doctor Name: | SARA GILLIS |
NPI Number: | 1871835033 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LADC |
License Number: | 303233 |
Business Practice Address: | 332 W Superior St 300 Duluth, MN - 558021808 |
Business Phone Number: | 2187224379 |
Business Fax Number: | |
Mailing Address: | 1900 Silver Lake Rd Nw, 110 NEW BRIGHTON |
State: | MN |
Postal Code: | 551121786 |
Phone Number: | 6516289566 |
Fax Number: | |
NPI Enumeration Date: | 03/26/2013 |
NPI Last Update Date: | 03/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 303233 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
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 |