Individual
DANIELLE TILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
6302 QUEENS CHAPEL RD, UNIVERSITY PARK, MD 20782-2130
(732) 687-7781
Mailing address
6302 QUEENS CHAPEL RD, UNIVERSITY PARK, MD 20782-2130
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
17315
MD
1041C0700X
Clinical Social Worker
17315
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
801750
—
MD
Enumeration date
10/03/2016
Last updated
06/10/2020
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