Individual
MS. LYNN GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., L.C.P.C.
Contact information
Practice address
24276 166TH SE AIRPORT ROAD, EAGLE BUTTE, SD 57625
(605) 964-0742
Mailing address
PO BOX 1711, EAGLE BUTTE, SD 57625-1711
(605) 964-0742
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SWP-LCPC-LIC-4562
MT
Other
Enumeration date
01/02/2014
Last updated
01/02/2014
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