Individual
RENE STEPHAN TILLICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
446 KAWAIHAE ST APT 119, HONOLULU, HI 96825-5202
(808) 394-2800
(562) 245-6419
Mailing address
446 KAWAIHAE ST APT 119, HONOLULU, HI 96825-5202
(808) 394-2800
(562) 245-6419
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY55
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56622
HMSA
HI
01
—
PSY55
QUEENS HEALTH CARE PLAN
HI
Enumeration date
09/07/2006
Last updated
05/31/2022
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