Provider Demographics
NPI:1952907693
Name:TILLER, EREIN S
Entity type:Individual
Prefix:
First Name:EREIN
Middle Name:S
Last Name:TILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3055 LEBANON PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-2230
Mailing Address - Country:US
Mailing Address - Phone:501-574-3050
Mailing Address - Fax:877-866-6152
Practice Address - Street 1:3500 LEBANON PK
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214
Practice Address - Country:US
Practice Address - Phone:501-574-3053
Practice Address - Fax:877-866-6152
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician