| Khadijah Tillman, Lcsw | |
|
4 Chelmsford Rd Rochester NY 14618-1755 | |
| (585) 713-2071 | |
| (585) 461-5503 |
| Full Name | Khadijah Tillman, Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4 Chelmsford Rd, Rochester, New York |
| Authorized Official Name and Position | Khadijah Tillman (PSYCHOTHERAPIST) |
| Authorized Official Contact | 5857132071 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Khadijah Tillman, Lcsw 4 Chelmsford Rd Rochester NY 14618-1755 Ph: (585) 713-2971 | Khadijah Tillman, Lcsw 4 Chelmsford Rd Rochester NY 14618-1755 Ph: (585) 713-2071 |
| NPI Number | 1003280140 |
|---|---|
| Provider Enumeration Date | 11/29/2015 |
| Last Update Date | 11/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003280140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 73081603 (New York) | Primary |
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