Individual
NICOLE GILLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2725 PINE GROVE RD, CUMMING, GA 30041-7103
(678) 772-7798
Mailing address
4290 MADISON HALL DR, CUMMING, GA 30028-3570
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/10/2022
Last updated
07/10/2022
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