Individual
DR. MICHELLE BANE TILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3777 ROUTE 130 SUITE 2, HARRISON CITY, PA 15636-1260
(412) 378-1058
Mailing address
3777 ROUTE 130 SUITE 2, HARRISON CITY, PA 15636-1260
(412) 378-1058
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS015111
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA056569
—
PA
Enumeration date
08/20/2006
Last updated
10/06/2021
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