Individual
MS. BRANDI LYNN GILLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
12368 STATE RD CC, FESTUS, MO 63028
(636) 232-3303
Mailing address
PO BOX 1225, FESTUS, MO 63028-7225
(636) 232-3303
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2017003233
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500089349
—
MO
Enumeration date
07/06/2016
Last updated
01/11/2024
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