| Wayne S. And Maureen P Tillman Llc | |
|
108 Baker St Maplewood NJ 07040-2531 | |
| (973) 715-6891 | |
| Not Available |
| Full Name | Wayne S. And Maureen P Tillman Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 108 Baker St, Maplewood, New Jersey |
| Authorized Official Name and Position | Maureen P Tillman (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 9737156891 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne S. And Maureen P Tillman Llc 108 Baker St Maplewood NJ 07040-2531 Ph: (973) 715-6891 | Wayne S. And Maureen P Tillman Llc 108 Baker St Maplewood NJ 07040-2531 Ph: (973) 715-6891 |
| NPI Number | 1538750500 |
|---|---|
| Provider Enumeration Date | 02/01/2021 |
| Last Update Date | 02/01/2021 |
| Certification Date | 02/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538750500 | NPI | - | NPPES |
| 1427112457 | Other | NJ | WAYNE S. TILLMAN |
| 1225361728 | Other | NJ | MAUREEN P. TILLMAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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