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General NPI Number Information
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NPI Number | 1003280850
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Entity Type | Individual
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Provider Name | KAYLEE DENISE ANDSAGER TILLEY LCMFT
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Gender | Female
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 83 QUAIL RD
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City | RICHMOND HILL
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State | GA
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Zip | 31324-3142
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Country | US
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Telephone | 620-960-3356
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 747
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City | MANHATTAN
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State | KS
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Zip | 66505-0747
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Country | US
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Telephone | 785-587-4300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT002130
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2849
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License Number State | KS
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