Individual
GINA DIANE GILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
3450 BROADWAY ST, BOULDER, CO 80304
(303) 441-1100
Mailing address
405 W CANNON ST, LAFAYETTE, CO 80026-1611
(720) 318-8866
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1221
CO
Other
Enumeration date
07/19/2010
Last updated
09/05/2018
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