Individual
ANGELA TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
186 MALGENE DRIVE RD, COCHRAN, GA 31014-5824
(478) 308-9208
Mailing address
186 MALGENE DRIVE RD, COCHRAN, GA 31014-5824
(478) 308-9208
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
452
GA
101YM0800X
Mental Health Counselor
Primary
—
—
103K00000X
Behavior Analyst
Primary
—
GA
172V00000X
Community Health Worker
—
GA
Other
Enumeration date
11/18/2015
Last updated
06/17/2026
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