Individual
ALYCIA TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
2080 W EAU GALLIE BLVD, MELBOURNE, FL 32935-3152
(407) 694-3603
(321) 296-7130
Mailing address
2080 W EAU GALLIE BLVD, MELBOURNE, FL 32935-3152
(407) 694-3603
(321) 296-7130
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
13199
CA
235Z00000X
Speech-Language Pathologist
Primary
SA17781
FL
Other
Enumeration date
08/06/2019
Last updated
04/06/2023
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