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Organization
THERAPEUTIC CENTER FOR CHANGE
Active
Organization
THERAPEUTIC CENTER FOR CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GILLIAN SQUILLACIOTI LCMHC (PSYCHOTHERAPIST)
(704) 755-5213
Entity
Organization
Contact information
Practice address
1566 UNION RD, GASTONIA, NC 28054-5301
(704) 755-5213
Mailing address
5132 NEWPORT LANDING WAY, GASTONIA, NC 28056-8521
(631) 974-9403
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/21/2020
Last updated
06/21/2020
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