Provider Demographics
NPI:1750608816
Name:GILLILAND, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:GILLILAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5102 S LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-8305
Mailing Address - Country:US
Mailing Address - Phone:208-640-6756
Mailing Address - Fax:
Practice Address - Street 1:202 E ANTON AVE STE 206
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-3779
Practice Address - Country:US
Practice Address - Phone:208-667-6095
Practice Address - Fax:208-667-6173
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-3370101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional