Individual
ELYSIA OUDEMANS-TILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
4702 WOODLAND ROAD, ELLICOTT CITY, MD 21042-6331
(240) 350-0026
Mailing address
PO BOX 6111, ELLICOTT CITY, MD 21042
(240) 350-0026
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904015085
VA
1041C0700X
Clinical Social Worker
Primary
10299
MD
1041C0700X
Clinical Social Worker
LC2000002110
DC
Other
Enumeration date
01/21/2022
Last updated
07/10/2023
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