| Doctor Name: | MS. FAHEEMAH B TILLMAN |
| NPI Number: | 1639305386 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1 Main St South Amboy, NJ - 088791142 |
| Business Phone Number: | 7327272555 |
| Business Fax Number: | |
| Mailing Address: | 282 S 11th Ave, HIGHLAND PARK |
| State: | NJ |
| Postal Code: | 089043418 |
| Phone Number: | 7329259264 |
| Fax Number: | |
| NPI Enumeration Date: | 06/09/2009 |
| NPI Last Update Date: | 06/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |