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Individual

MR. BRUCE ANDREW LILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
153 BALTIMORE ST, CUMBERLAND, MD 21502-2301
(301) 759-2852
Mailing address
700 ADAMS AVE, CUMBERLAND, MD 21502-3302
(301) 759-2852

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
00386
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6902000000873B
BLUE CROSSBLUE SHIELD
MD
Enumeration date
04/24/2007
Last updated
07/08/2007
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