Individual
DEMARCIO MIKEL GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7900 IVY LAKE LN, BARTLETT, TN 38133-2782
(901) 216-4119
Mailing address
7900 IVY LAKE LN, BARTLETT, TN 38133-2782
(901) 216-4119
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/25/2024
Last updated
10/25/2024
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