Individual
EVELYN M GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC II
Contact information
Practice address
187 W BROAD ST, SPARTANBURG, SC 29306-3234
(864) 582-7588
(864) 582-0431
Mailing address
187 W BROAD ST, SPARTANBURG, SC 29306-3234
(864) 582-7588
(864) 582-0431
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
001168
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001168
SCAADAC
SC
01
—
2192
STATE OF SC
SC
Enumeration date
01/16/2013
Last updated
01/16/2013
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