Individual
GENERA NICOLE GILLIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
155 STILLMERE CT, WINSTON SALEM, NC 27101-2311
(919) 539-7144
Mailing address
155 STILLMERE CT, WINSTON SALEM, NC 27101-2311
(919) 539-7144
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
9629
NC
Other
Enumeration date
01/09/2013
Last updated
04/09/2018
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