=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245518257
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | Y. T. HILL, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2011
-----------------------------------------------------
Last Update Date | 07/25/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2003 WILSON AVE
-----------------------------------------------------
City | PANAMA CITY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32405-4532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-481-0306
-----------------------------------------------------
Fax | 850-481-0309
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1705
-----------------------------------------------------
City | LYNN HAVEN
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32444-5905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | YOSHIKO HILL
-----------------------------------------------------
Credential | LMHC
-----------------------------------------------------
Telephone | 850-819-0314
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | MH8378
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------