Individual
JENNIFER DIANE TILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
216 HOSPITAL AVE, MARION, VA 24354-3157
(276) 783-8185
(276) 783-5030
Mailing address
770 W RIDGE RD, WYTHEVILLE, VA 24382-1187
(276) 223-3200
(276) 223-0617
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904008728
VA
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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