Individual
HOLLI GILLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1085 MAPLE STREET, FARMINGTON, MO 63640
(573) 756-5353
Mailing address
1085 MAPLE ST, FARMINGTON, MO 63640-1955
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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