Provider Demographics
NPI:1245463843
Name:GILLIE, RACHELLE MARIE (MS)
Entity type:Individual
Prefix:MS
First Name:RACHELLE
Middle Name:MARIE
Last Name:GILLIE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 PARK ST
Mailing Address - Street 2:#14
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-2470
Mailing Address - Country:US
Mailing Address - Phone:978-397-7073
Mailing Address - Fax:
Practice Address - Street 1:11 UNION ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1815
Practice Address - Country:US
Practice Address - Phone:978-685-1337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-29
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health