Provider Demographics
NPI:1972643377
Name:GILLIS & REINS INC
Entity type:Organization
Organization Name:GILLIS & REINS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:GILLIS
Authorized Official - Last Name:REINS
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:707-765-9021
Mailing Address - Street 1:35 MARIA DR
Mailing Address - Street 2:#861
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-3548
Mailing Address - Country:US
Mailing Address - Phone:707-765-9021
Mailing Address - Fax:707-584-2303
Practice Address - Street 1:35 MARIA DR
Practice Address - Street 2:#861
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-3548
Practice Address - Country:US
Practice Address - Phone:707-765-9021
Practice Address - Fax:707-584-2303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC29225106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty