Individual
DONNA L. TILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHRT-1
Contact information
Practice address
8 WESLEYAN ST, FORT FAIRFIELD, ME 04742-2010
(207) 473-9285
(207) 473-9403
Mailing address
8 WESLEYAN ST, FORT FAIRFIELD, ME 04742-2010
(207) 473-9285
(207) 473-9403
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103850000
—
ME
Enumeration date
04/09/2009
Last updated
04/09/2009
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