Individual
MARK GILLILAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.DIV
Contact information
Practice address
786 S 3RD ST, LANDER, WY 82520-3710
(406) 210-3388
Mailing address
786 S 3RD ST, LANDER, WY 82520-3710
(406) 210-3388
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
NONE
TX
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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