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Individual
MS. HEATHER DAWN GILLIES
Active
Individual
MS. HEATHER DAWN GILLIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1512013461
—
CA
Enumeration date
09/13/2012
Last updated
09/13/2012
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