National Provider Identifier

Susan Ann Tillman, MS ED

Susan Ann Tillman, MS ED is listed in the NPPES registry with a primary specialty of Counselor in Albion, NY and a listed phone number of (585) 682-0338.

NPI 1427134311Albion, NYCounselor

Profile Overview

NPI
1427134311
Provider Type
Individual
Primary Specialty
Counselor
Enumeration Date
October 31, 2006
Last Updated
July 08, 2007

Practice Location

  • 14369 Ridge RD West
  • Suite 2
  • Albion, NY 14411

Phone: (585) 682-0338

Mailing Address

  • 14192 Roosevelt Hwy
  • Waterport, NY 14571-9750

Specialties

  • Counselor (101Y00000X)
Full Record
NPI
1427134311
Entity Type
Individual
Last Name
Tillman
First Name
Susan
Middle Name
Ann
Name Prefix
Mrs.
Credential
MS ED
Provider Other Last Name
Tillman
Provider Other First Name
Susyn
Provider Other Middle Name
A. W.
Provider Other Name Prefix Text
MS.
Provider Other Credential Text
MS ED
Provider Other Last Name Type Code
2
Mailing Street Address
14192 Roosevelt Hwy
Mailing City
Waterport
Mailing State
NY
Mailing ZIP Code
14571-9750
Mailing Country
US
Mailing Phone
(585) 682-9740
Mailing Fax
(585) 589-7341
Practice Street Address
14369 Ridge RD West
Practice Address Line 2
Suite 2
Practice City
Albion
Practice State
NY
Practice ZIP Code
14411
Practice Country
US
Practice Phone
(585) 682-0338
Practice Fax
(585) 589-7341
Enumeration Date
October 31, 2006
Last Updated
July 08, 2007
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Counselor (101Y00000X)