Individual
ANIKA TILLERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
97 SUMMIT AVE, NEWARK, NJ 07112-1212
(347) 392-6515
Mailing address
97 SUMMIT AVE, NEWARK, NJ 07112-1212
(347) 392-6515
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
103853-1
NY
Other
Enumeration date
05/19/2020
Last updated
05/19/2020
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