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General NPI Number Information
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NPI Number | 1912298910
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Entity Type | Individual
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Provider Name | GARY JOSEPH ZILLI MA GUIDANCE & COUNSE
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Gender | Male
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Dates
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Enumeration Date | 04/25/2011
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Last Update Date | 04/25/2011
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Provider Practice Location Address
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Address Line | 20811 KELLY ROAD SUITE 103
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City | EASTPOINTE
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State | MI
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Zip | 48021
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Country | US
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Telephone | 586-445-2210
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Fax |
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Provider Business Mailing Address
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Address Line | 29567 EIFFEL
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City | WARREN
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State | MI
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Zip | 48088
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Country | US
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Telephone | 586-573-7828
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | C-00924
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License Number State | MI
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