Individual
GRACYN LONDON GILLELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
9750 AUTUMN CIR, DAVIDSON, NC 28036-9525
(704) 918-3316
Mailing address
9750 AUTUMN CIR, DAVIDSON, NC 28036-9525
(704) 918-3316
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
14292
NC
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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