Individual
AMANDA BROOKE TILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1051 OAK MOUNTAIN DR, PELHAM, AL 35124-1324
(205) 358-7311
Mailing address
3531 PINE HILL RD, MOODY, AL 35004-2716
(256) 326-4850
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-356390
AL
Other
Enumeration date
08/22/2024
Last updated
08/22/2024
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