Individual
CARLEY GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
106 SUNSET DR, VIDALIA, GA 30474-3017
(478) 461-2577
Mailing address
106 SUNSET DR, VIDALIA, GA 30474-3017
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT25-404494
GA
Other
Enumeration date
01/09/2025
Last updated
01/09/2025
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