Individual
MISS LUCRETIA BEANICA TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
1020 WYLIE SPRINGS CIR APT 17-201, CLOVER, SC 29710-0500
(980) 328-6234
Mailing address
1020 WYLIE SPRINGS CIR APT 17-201, CLOVER, SC 29710-0500
(980) 328-6234
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P011435
NC
Other
Enumeration date
06/20/2018
Last updated
06/20/2018
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