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General NPI Number Information
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NPI Number | 1497472583
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Entity Type | Organization
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Legal Business Name | GILLETTE COUNSELING LLC
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Dates
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Enumeration Date | 10/20/2022
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 1720 MERRILL AVE STE 401
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City | WAUSAU
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State | WI
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Zip | 54401-3427
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Country | US
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Telephone | 715-675-3888
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Fax | 715-675-2988
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Provider Business Mailing Address
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Address Line | 1720 MERRILL AVE STE 401
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City | WAUSAU
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State | WI
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Zip | 54401-3427
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Country | US
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Telephone | 715-675-3888
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Fax | 715-675-2988
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Authorized Official
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Title or Position | OWNER
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Name | PATRICIA GILLETTE
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Credential | MA
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Telephone | 715-675-3888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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