Individual
JENNIFER N. GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
11206 MAIN ST, MARTIN, KY 41649
(606) 285-3142
(606) 285-0575
Mailing address
104 S FRONT AVE, PRESTONSBURG, KY 41653-1614
(606) 886-8572
(606) 886-4433
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/23/2006
Last updated
07/08/2007
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