Healthcare Provider Details

I. General information

NPI: 1790249811
Provider Name (Legal Business Name): LINDA HYLTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7695 S COUNTY ROAD 25A
TIPP CITY OH
45371-9215
US

IV. Provider business mailing address

620 FLINTRIDGE DR
FAIRBORN OH
45324-4465
US

V. Phone/Fax

Practice location:
  • Phone: 937-426-2686
  • Fax:
Mailing address:
  • Phone: 937-479-7256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2404626
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: