Individual
MICHAEL GILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 ELM ST STE 2, PAOLI, IN 47454-1175
(502) 693-2719
Mailing address
350 KAHL CT, SELLERSBURG, IN 47172-1620
(502) 693-2719
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1534706
IN
Other
Enumeration date
10/25/2024
Last updated
10/25/2024
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