NPI 1013409911

Desmond Tillmon

Practitioner Behavior Technician Chesapeake, VA

Practice location

Address: 648 Independence Pkwy STE 300, Chesapeake, VA 23320-5208
Phone: (757) 776-0709
Mailing address: 21600 Oxnard St, Woodland Hills, CA 91367-4976

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X

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Registry record

NPI: 1013409911
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Jun 2018
Record last updated: 6 Jun 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.