Individual
DR. CHRISTOPHER TILLITSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3585 VINEVILLE AVE, MACON, GA 31204-1872
(478) 476-0403
(478) 476-9533
Mailing address
3585 VINEVILLE AVE., MACON, GA 31204
(478) 476-0403
(478) 476-9533
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
001724
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000521683B
—
GA
01
—
582147620
TAX ID
GA
Enumeration date
10/02/2006
Last updated
08/15/2012
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