Organization
COUNSELING ASSOCIATES CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMMOTHY NELSON TILLOTSON (OWNER)
(904) 471-5623
Entity
Organization
Contact information
Practice address
890 A1A BEACH BLVD, UNIT #5, ST AUGUSTINE, FL 32080-6776
(904) 471-5623
(904) 471-7545
Mailing address
890 A1A BEACH BLVD, UNIT #5, ST AUGUSTINE, FL 32080-6776
(904) 471-5623
(904) 471-7545
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/29/2009
Last updated
04/15/2009
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