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1992043038
JENNIFER A TILLISCH
FARGO, ND
NPI
1992043038
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: ND 1688)
Enumeration Date
2013-01-24
Last Update Date
2013-01-24
Business Address
JENNIFER A TILLISCH LAC
4227 9TH AVE SW
FARGO, ND 58103-2018
Phone number: 701-478-9535
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Mailing Address
JENNIFER A TILLISCH LAC
4227 9TH AVE SW
FARGO, ND 58103-2018
Phone number: 701-478-9535
Copy
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