Gillis, Martha M
Gillis, Martha M is an sole proprietor health care provider with primary practice located at 11166 Fairfax Blvd Suite 203, Fairfax VA 22030-5017. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gillis, Martha M can be contacted via phone (703) 819-8445.Contact Information
Primary practice address
11166 Fairfax Blvd Suite 203
Fairfax VA 22030-5017
Phone: (703) 819-8445
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 0810003445 | Virginia |
Profile Details
| NPI number | 1871657080 |
|---|---|
| LBN Legal business name | Gillis, Martha M |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 21st, 2006 |
| Last updated | Nov 29th, 2011 - about 13 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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