Tillis, David Roger
Tillis, David Roger is an sole proprietor health care provider with primary practice located at 9635 Ventana Way Suite 101, Johns Creek GA 30022-8620. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Tillis, David Roger can be contacted via phone (770) 495-6339.Contact Information
Primary practice address
9635 Ventana Way Suite 101
Johns Creek GA 30022-8620
Phone: (770) 495-6339
Fax: (770) 495-6338
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | MAC030853 | Georgia |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | LPC001626 | Georgia |
Profile Details
| NPI number | 1114159696 |
|---|---|
| LBN Legal business name | Tillis, David Roger |
| Credentials | LPC, NCC, MAC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 17th, 2009 |
| Last updated | Aug 17th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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