Individual provider · Type 1 NPI
Detra S. Gillians
Mental Health Counselor · Bronx, NY
NPI number
1619644754
Active
Practice location
3174 Riverdale Ave
Bronx, NY 10463-3839
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
Another provider at this address
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About NPI 1619644754
Detra S. Gillians's National Provider Identifier is 1619644754, issued on Aug 26, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Bronx, NY. The record was last updated on Oct 18, 2021.