Individual
MOLLY A TILLESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
10243 W NATIONAL AVE, WEST ALLIS, WI 53227-2028
(414) 604-7217
Mailing address
10243 W NATIONAL AVE, WEST ALLIS, WI 53227-2028
(414) 604-7217
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/02/2010
Last updated
08/22/2013
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