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Individual

THERESA GILL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC

Contact information

Practice address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Mailing address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
E.1800746
OH
101YP2500X
Professional Counselor
E.1800746
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0416997
OH
Enumeration date
09/07/2020
Last updated
07/11/2021
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