Individual
GYPSY GILLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
291 E SWANSON AVE, WASILLA, AK 99654-7004
(907) 376-3275
Mailing address
291 E SWANSON AVE, WASILLA, AK 99654-7004
(907) 376-3275
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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