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Individual
MILDRED BENNETT TILLMAN
Active
Individual
MILDRED BENNETT TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC-S,LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6864
SC
101YM0800X
Mental Health Counselor
S10076
NC
Other
Enumeration date
05/20/2013
Last updated
11/20/2024
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