Ty'Ionna Nicole Gillam
Counselor, Addiction (Substance Use Disorder) in Walterboro, SC. Individual provider (NPI-1).
NPI number1164096970
StatusActive
Last updated in NPPESMay 17, 2021
Details
- NPI
- 1164096970
- Entity type
- Individual (NPI-1)
- Name
- Ty'Ionna Nicole Gillam
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 17, 2021
- Certification date
- May 17, 2021
- Last updated
- May 17, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
Practice location
1439 Thunderbolt DrWalterboro, SC 29488-9341
Phone 843-539-2211
Mailing address
1439 Thunderbolt DrWalterboro, SC 29488-9341
Phone 843-539-2211
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All 20 Addiction (Substance Use Disorder) Counselor providers in Walterboro · All 480 providers in Walterboro
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