Individual
DONALD AMOS LILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1800 TULLY RD, SUITE F, MODESTO, CA 95350-2946
(209) 576-1750
Mailing address
12414 MILLS ST, GROVELAND, CA 95321-9322
(209) 962-6540
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
LMFT 19577
CA
Other
Enumeration date
05/01/2012
Last updated
05/01/2012
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