| NPI | 1942299011 |
|---|---|
| Other Name | JASON ROBERT GILLESPIE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-10767) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM M-1878) |
| 106H00000X Marriage & Family Therapist (Licence: AZ LMFT-0256) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2007-07-08 |