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Individual

ANTHONY P GILLETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
520 N 28TH AVE, STE 200, WAUSAU, WI 54401
(715) 848-1346
(715) 848-0640
Mailing address
520 N 28TH AVE, STE 200, WAUSAU, WI 54401
(715) 848-1346
(715) 848-0640

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
466057
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39006900
WI
Enumeration date
06/08/2006
Last updated
07/08/2007
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