Individual
JODI TILLEY PROVINCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1260 COLLEGE AVE STE 1, WILKESBORO, NC 28697-2700
(336) 818-0733
Mailing address
1260 COLLEGE AVE STE 1, WILKESBORO, NC 28697-2700
(336) 818-0733
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5534
NC
Other
Enumeration date
02/23/2007
Last updated
02/01/2012
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