Individual
JACQUICE GILLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3450 HIGHWAY 80 W, JACKSON, MS 39209-7201
(601) 321-2400
Mailing address
138 WILLIAM MCKINLEY CIR, JACKSON, MS 39213-3136
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/10/2026
Last updated
04/10/2026
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