Individual
MR. JENTRY EDWARD TILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
CAMP JOSEPH T ROBINSON, NORTH LITTLE ROCK, AR 72199-0001
(501) 212-5441
Mailing address
PO BOX 009, NORTH LITTLE ROCK, AR 72199-0001
(501) 212-5441
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7490-C
AR
Other
Enumeration date
07/13/2011
Last updated
12/22/2016
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