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Individual

MRS. LISA ANNE TILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SPEECH THERAPIST

Contact information

Practice address
306 GORDON AVE, SHERRILL, NY 13461-1417
(315) 363-7689
Mailing address
306 GORDON AVE, SHERRILL, NY 13461-1417
(315) 363-7689

Taxonomy

Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
1007907
NY

Other

Enumeration date
06/22/2011
Last updated
06/22/2011
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