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1619644754
DETRA S GILLIANS
BRONX, NY
NPI
1619644754
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2021-08-26
Last Update Date
2021-10-18
Business Address
DETRA S GILLIANS
3174 RIVERDALE AVE
BRONX, NY 10463-3839
Phone number: 347-450-6164
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Mailing Address
DETRA S GILLIANS
3174 RIVERDALE AVE
BRONX, NY 10463-3839
Phone number: 347-450-6164
Copy
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