Individual
MARTHA ELIZABETH TILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, SSP
Contact information
Practice address
222 OLD THAYER MILL RD, TROY, NC 27371-2009
(910) 282-7927
Mailing address
222 OLD THAYER MILL RD, TROY, NC 27371-2009
(910) 282-7927
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
470535F
WA
103TS0200X
School Psychologist
Primary
766899
NC
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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