Organization
TIER1 PERFORMANCE COACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN TILLINGHAST PHD (MENTAL PERFORMANCE COACH)
(302) 357-0029
Entity
Organization
Contact information
Practice address
347 JESSICA DR, MIDDLETOWN, DE 19709-4013
(302) 357-0029
Mailing address
347 JESSICA DR, MIDDLETOWN, DE 19709-4013
(302) 357-0029
Taxonomy
Speciality
Code
Description
License number
State
103TE1100X
Exercise & Sports Psychologist
Primary
—
—
Other
Enumeration date
01/28/2021
Last updated
01/28/2021
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