Healthcare Provider Details

I. General information

NPI: 1437599107
Provider Name (Legal Business Name): FELICIA ANDREA HILL OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 W PARK AVE
VALDOSTA GA
31602-2507
US

IV. Provider business mailing address

1311 BAYWOOD RD
DOTHAN AL
36305-8414
US

V. Phone/Fax

Practice location:
  • Phone: 229-253-8500
  • Fax: 229-253-8522
Mailing address:
  • Phone: 229-254-1054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number6273
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: