Individual
ANNA TILLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LPA
Contact information
Practice address
647 BRAWLEY SCHOOL RD STE 104, MOORESVILLE, NC 28117-6876
(704) 703-8588
Mailing address
3402 DENADA PATH, DURHAM, NC 27707-6039
(336) 317-2844
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
Primary
5446
NC
Other
Enumeration date
10/19/2018
Last updated
02/15/2023
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