Healthcare Provider Details

I. General information

NPI: 1972321487
Provider Name (Legal Business Name): TEAIRIA MARIE HILL INDEPENDENT PROVIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TEAIRIA MARIE HILL INDEPENDENT PROVIDER

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3936 HOILES AVE
TOLEDO OH
43612-1258
US

IV. Provider business mailing address

3936 HOILES AVE
TOLEDO OH
43612-1258
US

V. Phone/Fax

Practice location:
  • Phone: 567-420-9364
  • Fax:
Mailing address:
  • Phone: 567-420-9364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: