Laura Michelle Tillman, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP-1803 Issued in NV

Practice address

2012 S Jones Blvd
Las Vegas, NV 89146-3151

Phone

(803) 422-7451

NPI assigned

May 31, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433030400000",
    "number": "1285014753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463151",
            "telephone_number": "803-422-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463151",
            "telephone_number": "803-422-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "LAURA",
        "middle_name": "MICHELLE",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-31",
        "last_updated": "2015-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NV",
            "license": "SP-1803",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008791",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howars Tillis
• Jasmine Tillis
• Jasmine Dominique Tillison
• Deshauna Tillman
• Ebony Tillman
• Madison Tillman
• Makayla Tillman
• Marticka Simone Tillman, RN
• Maurica Tillman
• Mylon Tillman

• Speech-Language Pathologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Speech-Language Pathologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.