Individual
AMANDA JOY TILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1262 E 17TH ST, IDAHO FALLS, ID 83404-6126
(208) 346-0688
Mailing address
1017 JAYLEE DR UNIT 3, RIGBY, ID 83442-4976
(208) 716-5288
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3071859
ID
101YP2500X
Professional Counselor
BBH-LCPC-LIC-82393
MT
Other
Enumeration date
03/10/2025
Last updated
04/08/2026
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