Individual
SAMANTHA D GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
732 BECKMAN ST, DAYTON, OH 45410-2165
(937) 253-1680
Mailing address
732 BECKMAN ST, DAYTON, OH 45410-2165
(937) 253-1680
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C2002677
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDCIII.161844
OH
Other
Enumeration date
02/26/2018
Last updated
01/22/2025
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