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Individual

MS. KATHY F. TILLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, RN, LPCC

Contact information

Practice address
9301 INDIAN SCHOOL RD NE, STE. 101-A, ALBUQUERQUE, NM 87112-2884
(505) 480-9782
(505) 271-1714
Mailing address
9301 INDIAN SCHOOL RD NE, STE. 101-A, ALBUQUERQUE, NM 87112-2884
(505) 480-9782
(505) 271-1714

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1647
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
35425
PRESBYTERIAN HEALTH PLAN
NM
05
B6225
NM
01
NM101079
VALUEOPTIONS OF NM
NM
01
R81I
BCBS
NM
Enumeration date
12/11/2006
Last updated
07/09/2007
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