Individual provider · Type 1 NPI
Jessica Ann Gillam
Mental Health Counselor · Phoenix, AZ
NPI number
1417680901
Active
Practice location
2022 W Blaylock Dr
Phoenix, AZ 85085-1718
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | LPC12819 (AZ) |
Mental Health Counselor: Definition to come...
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About NPI 1417680901
Jessica Ann Gillam's National Provider Identifier is 1417680901, issued on Jul 2, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Phoenix, AZ. The record was last updated on Jul 2, 2022.