Individual
GREG CLAYTON TILLMAN-WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1376 NE WALNUT ST, ROSEBURG, OR 97470-2242
(541) 784-8224
Mailing address
2630 AUSTIN RD, ROSEBURG, OR 97471-4512
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C1764
OR
Other
Enumeration date
05/25/2010
Last updated
05/25/2010
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