Individual
HEATHER GILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31882 CAMINO CAPISTRANO, 108, SAN JUAN CAPISTRANO, CA 92675-3222
(949) 487-6080
Mailing address
34101 BLUE LANTERN ST, DANA POINT, CA 92629-2504
(949) 292-3336
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ASW26106
CA
Other
Enumeration date
04/11/2011
Last updated
04/11/2011
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