Most Relevant Information
Provider Data
| NPI Number: | 1003420498 |
| Provider Name: | JUSTIN TRAVIS GILLESPIE LLMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 6801103633 |
Most Important Dates
| Enumeration Date: | 09/02/2020 |
| Last Updated: | 04/01/2023 |
Provider Practice Location
17940 FARMINGTON RD
LIVONIA
MI
481524444
Practice Location Phone/Fax
| Phone: | 5862106148 |
| Fax: |
Provider Mailing Location
17940 FARMINGTON RD STE 302
LIVONIA
MI
481523159
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |