Individual
AUDRA N GILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1701 ENTERPRISE RD, MITCHELLVILLE, MD 20721-2213
(301) 442-1990
(301) 627-1806
Mailing address
16314 BOSWELL PL, UPPER MARLBORO, MD 20772-3286
(301) 442-1990
(301) 627-1806
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13071
MD
1041C0700X
Clinical Social Worker
LC50078183
DC
Other
Enumeration date
08/09/2007
Last updated
09/07/2011
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