MEDICARE: NAIA TILGHMAN LPC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1225447253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAIA TILGHMAN LPC

Provider Business Mailing Address
First Line	:	11720 AMBER PARK DR STE 160
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30009-2271
Country	:	US
Telephone Number	:	678-696-0463
Fax Number	:

Provider Business Practice Location Address
First Line	:	11720 AMBER PARK DR STE 160
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30009-2271
Country	:	US
Telephone Number	:	678-696-0463
Fax Number	:

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

Provider Enumeration Date	:	08/04/2014
Last Update Date	:	01/19/2024

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