Individual
JUSTIN TRAVIS GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LLMSW
Contact information
Practice address
17940 FARMINGTON RD, LIVONIA, MI 48152-4444
(586) 210-6148
Mailing address
17940 FARMINGTON RD STE 302, LIVONIA, MI 48152-3159
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6801103633
MI
104100000X
Social Worker
Primary
6801111107
MI
Other
Enumeration date
09/02/2020
Last updated
04/01/2023
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