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Individual

MS. DENISE JENEE TILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMBT

Contact information

Practice address
4310 PARK RD APT 102, CHARLOTTE, NC 28209-0006
(704) 412-5395
Mailing address
13004 ASHEFORD WOODS LN, CHARLOTTE, NC 28278-7845
(434) 944-7702

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
12317
SC
225700000X
Massage Therapist
Primary
19217
NC

Other

Enumeration date
10/11/2021
Last updated
11/13/2024
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