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Individual
JORDANNA TILLINGHAST
Active
Individual
JORDANNA TILLINGHAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, NCAC-I, CAC-II
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15050111
SC
101YA0400X
Addiction (Substance Use Disorder) Counselor
93157
SC
Other
Enumeration date
05/08/2015
Last updated
05/08/2015
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