Healthcare Provider Details

I. General information

NPI: 1477488302
Provider Name (Legal Business Name): JOY MICHELLE GILMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 JEFFCO BLVD STE 213
ARNOLD MO
63010-2737
US

IV. Provider business mailing address

1623 JEFFCO BLVD STE 213
ARNOLD MO
63010-2737
US

V. Phone/Fax

Practice location:
  • Phone: 636-633-0728
  • Fax:
Mailing address:
  • Phone: 636-633-0728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2026016185
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: