Individual
DEVONNA TILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1420 S MAIN ST, HOPE, AR 71801-0000
(870) 777-4848
(870) 777-2410
Mailing address
829 HALBERT ST, MALVERN, AR 72104-2607
(501) 332-4400
(501) 332-4400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A2009117
AR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227972795
—
AR
Enumeration date
06/29/2015
Last updated
06/18/2021
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