Individual
REBECCA D AADLAND TILLOTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT, NCC
Contact information
Practice address
6542 REGENCY LN STE 209, EDEN PRAIRIE, MN 55344
(952) 926-7500
(952) 903-9257
Mailing address
15492 ELM RD, MAPLE GROVE, MN 55311-3922
(952) 926-7500
(952) 903-9257
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
NCC 63137
—
106H00000X
Marriage & Family Therapist
Primary
1084
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350J1AA
BLUE CROSS BLUE SHIELD
MN
01
—
350J2SC
BLUE CROSS BLUE SHIELD
MN
01
—
489632
VALUE OPTIONS
MN
01
—
50078-01
BHP
MN
01
—
602360
MAYO
MN
01
—
6293456
MEDICA
MN
01
—
6879612
MINNESOTA TAX ID
MN
05
—
6879612
—
MN
01
—
846855900
MHCP
MN
Enumeration date
11/09/2006
Last updated
06/16/2018
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