Provider Information for 1669844213
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Mrs. LEAH GILLAM LCSW
Sex: Female
NPI: 1669844213
Last Updated: 2016-03-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1669844213 | ||||||||||||
| Enumeration Date | 2015-10-22 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 66308 HOUSTON, TX 77266-6308 United States Phone: 832-548-5000 | Fax: | ||||||||||||
| Primary Practice Address | 730 INDEPENDENCE BLVD. BAYTOWN, TX 77521 United States Phone: 713-351-7360 | Fax: | ||||||||||||
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