Individual
JERMEL A. GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2310 N CHARLES ST, BALTIMORE, MD 21218-5127
(410) 799-3012
(410) 230-2687
Mailing address
2310 N CHARLES ST, BALTIMORE, MD 21218-5127
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
G08906
MD
Other
Enumeration date
12/03/2009
Last updated
12/03/2009
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