Individual
THERESA LYNN GILLIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTRL, CLT-LANA
Contact information
Practice address
187 BIRNAMWOOD DR, CHAPEL HILL, NC 27516-9610
(919) 967-8583
Mailing address
187 BIRNAMWOOD DR, CHAPEL HILL, NC 27516-9610
(919) 967-8583
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5631
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0443M
BCBSNC DME
NC
01
—
1407M
BCBS NC
NC
01
—
186565
MEDCOST
NC
Enumeration date
05/15/2007
Last updated
03/25/2009
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