person
Mary Gates-gully, MS,CADC
Addiction (Substance Use Disorder) Counselor in Centralia, Illinois
NPI 1013105295

Mary Gates-gully is an Addiction (Substance Use Disorder) Counselor based in Centralia, IL and is specialized in Addiction (Substance Use Disorder). Mary Gates-gully practices in Centralia, IL and has the professional credentials of MS,CADC. The NPI Number for Mary Gates-gully is 1013105295 and holds a License No. 21816 (Illinois).

The current practice location address for Mary Gates-gully is 904 E. Martin Luther King Drive, Centralia, IL and can be reached out via phone at 618-533-1391 and via fax at 618-533-0012.

Location: 904 E. Martin Luther King Drive, Centralia, IL, 62801
person
Provider Profile Details
NPI Number
1013105295
Provider Name
Mary Gates-gully
Credential
MS,CADC
Provider Entity Type
Individual
Gender
Female
Address
904 E. Martin Luther King Drive, Centralia, IL, 62801
Phone Number
618-533-1391
Fax Number
618-533-0012
Provider Enumeration Date
10/12/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
370915481007 05 IL
institution
Provider Business Practice Location Address Details
Address
904 E. Martin Luther King Drive
City
State
Zip
62801
Phone Number
618-533-1391
Fax Number
618-533-0012
person
Provider Business Mailing Address Details
Address
904 E. Martin Luther King Drive
City
State
Zip
62801
Phone Number
618-533-1391
Fax Number
618-533-0012
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
21816 (Illinois)
Definition
Definition to come...
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