| NPI | 1265744726 |
|---|---|
| Former Name | LESLEY R GILLUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 35001960A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0001408) |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2020-11-05 |