Individual
JA'WANN GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
511 PERRY ST, DEFIANCE, OH 43512-2123
(419) 782-9920
Mailing address
511 PERRY ST, DEFIANCE, OH 43512-2123
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
01/05/2024
Last updated
03/21/2025
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