Provider Demographics
NPI:1417694357
Name:TILLER, REBECCA L (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:TILLER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 W 7TH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2836
Mailing Address - Country:US
Mailing Address - Phone:509-992-5038
Mailing Address - Fax:509-326-5521
Practice Address - Street 1:705 W 7TH AVE STE B
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2836
Practice Address - Country:US
Practice Address - Phone:509-992-5038
Practice Address - Fax:509-326-5521
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006116101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health