Individual
MARCEL TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6724 RANDALL LN, HIGHLAND, CA 92346-6284
(909) 633-3723
Mailing address
6724 RANDALL LN, HIGHLAND, CA 92346-6284
(909) 633-3723
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
35898
CA
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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