Individual
DR. MICHAEL GEORGE TILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., LCSW
Contact information
Practice address
17844 E 23RD ST S, INDEPENDENCE, MO 64057-1840
(816) 254-3652
(816) 254-9243
Mailing address
17844 E 23RD ST S, INDEPENDENCE, MO 64057-1840
(816) 254-3652
(816) 254-9243
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
2008004864
MO
1041C0700X
Clinical Social Worker
Primary
2007033658
MO
Other
Enumeration date
09/29/2008
Last updated
07/08/2014
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