Individual
MRS. AISHA GILLIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4390 LINDELL BLVD STE 200, SAINT LOUIS, MO 63108-2735
(314) 956-0547
Mailing address
8501 CRIXDALE AVE, SAINT LOUIS, MO 63132-4027
(314) 608-2079
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2019000930
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019000930
LPC MO
MO
Enumeration date
01/26/2021
Last updated
01/26/2021
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