Individual
DR. GLORIA YRIZARRY TILLMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
14 RED HAWK RD NO, COLTS NECK, NJ 07722
(732) 946-3648
Mailing address
14 RED HAWK RD NO, COLTS NECK, NJ 07722
(732) 946-3648
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
NJ1720
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720
NJ LICENSE
—
Enumeration date
05/01/2008
Last updated
05/01/2008
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