Individual
MR. MICHAEL JEROME GILLIARD II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, NCC
Contact information
Practice address
50 AVIATOR PLZ STE 105N, ST SIMONS ISLAND, GA 31522-0140
(404) 549-6987
(404) 795-5787
Mailing address
110 LANTANA CT, BRUNSWICK, GA 31520-2211
(843) 471-3511
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC010398
GA
Other
Enumeration date
06/05/2017
Last updated
04/03/2019
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