Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 071009014 | IL |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 071009014 | IL |
Y | 103G00000X | Clinical Psychologist | 071009014 | IL |
Y | 103TC0700X | Clinical Psychologist | 071009014 | IL |
N | 103TC1900X | Counseling Psychologist | 071009014 | IL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 071009014 | IL |
N | 103TF0000X | Family Psychologist | 071009014 | IL |
N | 103TF0200X | Forensic Psychologist | 071009014 | IL |
N | 103TP2701X | Group Psychotherapist | 071009014 | IL |
NPI | 1033735311 |
---|---|
Provider Name | Christian Hope Gillespie |
First Address | Carterville, IL 62918-2382 |
Second Address | Carbondale, IL 62901-1735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2020 |
Last Update Date | 22/06/2020 |