# PATRICK EDWARD GILLILAND, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942624580
- **Authorized official:** MR. PATRICK EDWARD GILLILAND LMFT (MARRIAGE AND FAMILY THERAPIST)
- **Authorized official phone:** (602) 463-5673

## Contact information

- **Practice address:** 9635 VENTANA WAY, SUITE 101, JOHNS CREEK, GA 30022-8620
- **Practice address phone:** (678) 366-8862
- **Practice address fax:** (678) 739-0119
- **Mailing address:** 9635 VENTANA WAY, SUITE 101, JOHNS CREEK, GA 30022-8620
- **Mailing address phone:** (678) 366-8862
- **Mailing address fax:** (678) 739-0119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | MFT001143 | GA | Yes |

## Other

- **Enumeration date:** 02/18/2014
- **Last updated:** 02/18/2014