Individual
DR. KATHLEEN SUZANNE TILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2100 S COLUMBIA ROAD, SUITE 202, FAMILY INSTITUTE, PC, GRAND FORKS, ND 58201
(701) 282-9510
Mailing address
2100 S COLUMBIA ROAD, SUITE 202, FAMILY INSTITUTE, PC, GRAND FORKS, ND 58201
(701) 282-9510
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
03/15/2017
Last updated
03/15/2017
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