Bara Benita Tillman

NPI #1225676364 in Suwanee, Georgia

Provider Information

NPI Number: 1225676364
Entity Type: Individual
Name: Bara Benita Tillman
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Dec 19, 2019
Last Updated: Dec 19, 2019

Practice Location

Address: 4000 SMITHTOWN RD STE 200
City: Suwanee
State: Georgia
ZIP Code: 30024-6560
Phone: (470) 632-4990

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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