Individual
GILFORD LEE GILLEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
707 SOUTHFIELD RD., SHREVEPORT, LA 71106
(318) 869-1632
(318) 869-1633
Mailing address
707 SOUTHFIELD RD., SHREVEPORT, LA 71106
(318) 869-1632
(318) 869-1633
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5077
LA
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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