Individual
JENNIFER GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W 3RD AVE, CORSICANA, TX 75110-4562
(903) 870-5925
Mailing address
500 W 3RD AVE, CORSICANA, TX 75110-4562
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209595
TX
Other
Enumeration date
11/25/2014
Last updated
11/25/2014
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