Individual
MS. SUZANNA MARIE TILLOTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1701 N BEACH ST, #2, BOISE, ID 83706-1117
(208) 672-8130
(208) 672-8130
Mailing address
3257 CATALINA LN, BOISE, ID 83705-4006
(208) 672-8130
(208) 672-8130
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
116424-3902
UT
106H00000X
Marriage & Family Therapist
Primary
LMFT - 11
ID
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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