Organization
JODI PROVINCE COUNSELING SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI TILLEY PROVINCE LPCS (OWNER)
(336) 818-0733
Entity
Organization
Contact information
Practice address
714 CAROLINA AVE STE A, YADKINVILLE, NC 27055-7760
(336) 818-0733
(336) 818-0734
Mailing address
1260 COLLEGE AVE STE 1, WILKESBORO, NC 28697-2700
(336) 818-0733
(336) 818-0734
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
01/22/2019
Last updated
10/12/2020
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