Individual
MR. JUSTIN JACOB GILLIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSW
Contact information
Practice address
179 NORTHAMPTON ST, EASTHAMPTON, MA 01027-1057
(413) 529-9047
Mailing address
122 NAUGATUCK AVE, MILFORD, CT 06460-6036
(203) 508-5053
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/24/2013
Last updated
09/09/2013
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