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Individual

ALEXIS NICOLE TILLERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LLMSW

Contact information

Practice address
30000 HIVELEY ST, INKSTER, MI 48141-1089
(173) 472-8340
Mailing address
30451 MARIMOOR ST, BEVERLY HILLS, MI 48025-5041
(248) 804-1595

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6851106976
MI
1041C0700X
Clinical Social Worker
6801106976
MI
1041C0700X
Clinical Social Worker
6851106976
MI

Other

Enumeration date
10/13/2020
Last updated
08/04/2022
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