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Individual

PAUL F GILLETTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
610 E.SOUTHPORT RD., SUITE 100, INDIANAPOLIS, IN 46227-8592
(317) 783-8383
(317) 782-6929
Mailing address
610 E SOUTHPORT RD, SUITE 100, INDIANAPOLIS, IN 46227-8590
(317) 783-8383
(317) 782-6929

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34001884A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11541288
CAQH
IN
Enumeration date
08/20/2006
Last updated
07/07/2009
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