Individual
AMBER GILLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-3105
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/05/2020
Last updated
01/25/2024
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