Individual
PROF. JAMES L GILLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS LPC CRADC CCDP-D
Contact information
Practice address
1015 LANTON RD, WEST PLAINS, MO 65775-3854
(417) 256-2570
(417) 265-6497
Mailing address
1022 W 2ND ST, WEST PLAINS, MO 65775-2367
(417) 818-7204
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2007015287
MO
Other
Enumeration date
04/17/2013
Last updated
04/17/2013
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