Individual
MR. DOUGLAS ROGER TILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS ED, PLMHP
Contact information
Practice address
615 N ELM ST, GRAND ISLAND, NE 68801-4254
(308) 395-1025
Mailing address
1919 W 39TH ST APT F8, KEARNEY, NE 68845-2778
(308) 352-8568
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
8297
NE
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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