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Individual

WILLISIA M TILLERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
8461 HIGHWAY 43, AMITE, LA 70422-8303
(985) 517-6654
Mailing address
8461 HIGHWAY 43, AMITE, LA 70422-8303
(985) 517-6654

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6173
LA

Other

Enumeration date
08/16/2010
Last updated
08/16/2010
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