MEDICARE: MRS. MOLLY NICOLE HILL MSW, LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1467174193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MOLLY NICOLE HILL MSW, LMSW

Provider Business Mailing Address
First Line	:	PO BOX 247
Second Line	:
City	:	FAIR GROVE
State	:	MO
Zip	:	65648-0247
Country	:	US
Telephone Number	:	417-818-8771
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 E BENNETT ST STE B
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65804-1427
Country	:	US
Telephone Number	:	417-409-3008
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2022
Last Update Date	:	09/19/2022

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