Individual
MRS. ASTOR CHARLENE GILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S., L.A.D.C.
Contact information
Practice address
59 FRANKLIN ST., SUITE B, ELLSWORTH, ME 04605
(207) 667-2730
(207) 669-4027
Mailing address
59 FRANKLIN ST., SUITE B, ELLSWORTH, ME 04605
(207) 667-2730
(207) 669-4027
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC2639
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
256940099
MAINECARE
ME
Enumeration date
12/02/2009
Last updated
12/02/2009
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