MEDICARE: LILLY ANN TOWLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1578250080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILLY ANN TOWLE

Provider Business Mailing Address
First Line	:	3617 CURRAN AVE APT 6
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68803-1245
Country	:	US
Telephone Number	:	402-937-3340
Fax Number	:

Provider Business Practice Location Address
First Line	:	3617 CURRAN AVE APT 6
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68803-1245
Country	:	US
Telephone Number	:	402-937-3340
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2023
Last Update Date	:	04/24/2023

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Directions to “ LILLY ANN TOWLE ” Practice Location

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