Gilliam, Mary L A

Gilliam, Mary L A is an sole proprietor health care provider with primary practice located at 17284 Slover Ave Suite #105, Fontana CA 92337-7584. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gilliam, Mary L A can be contacted via phone (909) 609-2800.

Contact Information

Primary practice address
17284 Slover Ave Suite #105 Fontana CA 92337-7584
Phone: (909) 609-2800
Fax: (909) 609-3805
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCS14326 California

Profile Details

NPI number 1518347343
LBN Legal business name Gilliam, Mary L A
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 6th, 2015
Last updated Jun 6th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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