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Individual

MR. MARK STEVEN TILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
2887 MELBOURNE ST, SALT LAKE CITY, UT 84106-4071
(801) 485-2538
Mailing address
2887 MELBOURNE ST, SALT LAKE CITY, UT 84106-4071
(801) 485-2538

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
137552-3501
UT

Other

Enumeration date
04/23/2010
Last updated
04/23/2010
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