Individual
MRS. JOAN COLUMBIA TILLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1130 N NIMITZ HWY, SUITE A203, HONOLULU, HI 96817-4579
(808) 537-9998
(808) 738-5821
Mailing address
1130 N NIMITZ HWY, SUITE A203, HONOLULU, HI 96817-4579
(808) 537-9998
(808) 738-5821
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW3113
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
052502
—
HI
01
—
R60088
HMSC BCBS
—
Enumeration date
08/07/2006
Last updated
07/08/2007
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