Individual
MICHAEL H GREMILLION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MHPS / RSPS
Contact information
Practice address
4312 MATT DR, KILLEEN, TX 76549-4779
(409) 466-9888
Mailing address
PO BOX 690914, KILLEEN, TX 76549-0016
(409) 466-9888
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1533-11
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1533-1121
TEXAS CERTIFICATION BOARD OF ADDICTION PROFESSIONALS
TX
01
—
50363-0122
TEXAS CERTIFICATION BOARD OF ADDICTION PROFESSIONALS
TX
Enumeration date
09/12/2022
Last updated
09/12/2022
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