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General NPI Number Information
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NPI Number | 1972643377
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Entity Type | Organization
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Legal Business Name | GILLIS & REINS INC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 35 MARIA DR #861
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City | PETALUMA
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State | CA
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Zip | 94954-3548
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Country | US
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Telephone | 707-765-9021
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Fax | 707-584-2303
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Provider Business Mailing Address
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Address Line | 35 MARIA DR #861
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City | PETALUMA
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State | CA
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Zip | 94954-3548
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Country | US
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Telephone | 707-765-9021
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Fax | 707-584-2303
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MARY GILLIS REINS
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Credential | MFT
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Telephone | 707-765-9021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC29225
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License Number State | CA
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