Individual
SHAWNYETTA DANYEL TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW,LCSW-A
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 286-1670
Mailing address
2812 ROSEMEADE DR, FAYETTEVILLE, NC 28306-9102
(910) 286-1670
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
P016608
NC
Other
Enumeration date
08/12/2021
Last updated
08/12/2021
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