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General NPI Number Information
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NPI Number | 1164112637
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Entity Type | Individual
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Provider Name | KANISHA HILL
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Gender | Female
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Dates
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Enumeration Date | 05/09/2023
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 500 WESTOVER DR # 13619
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City | SANFORD
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State | NC
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Zip | 27330-8941
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Country | US
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Telephone | 323-205-7088
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Fax |
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Provider Business Mailing Address
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Address Line | 230 SARLEE DR
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City | LA MARQUE
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State | TX
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Zip | 77568-6258
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Country | US
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Telephone | 409-989-8027
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 89923
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License Number State | TX
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