Individual
JENNIFER D TILLMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
107 VISTA OAKS DR, SUITE C, LEXINGTON, SC 29072-8230
(803) 957-5856
(803) 957-5856
Mailing address
59 EASTPINE CT, COLUMBIA, SC 29212-2484
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
851
SC
Other
Enumeration date
09/19/2010
Last updated
09/19/2010
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