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Individual

CARA JO GILLISPIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CDCA

Contact information

Practice address
220 N PLAZA BLVD, CHILLICOTHE, OH 45601-1787
(740) 851-6493
Mailing address
902 GALLIA ST, PORTSMOUTH, OH 45662-4139
(740) 517-9422

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
166356
104100000X
Social Worker
Primary
S.2004708
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0096642
ND
Enumeration date
06/22/2018
Last updated
12/17/2021
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