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General NPI Number Information
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NPI Number | 1760892665
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Entity Type | Individual
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Provider Name | MISTIE HILL
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Gender | Female
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 04/30/2014
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Provider Practice Location Address
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Address Line | 1923 DAVIS DRIVE
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City | GLENWOOD
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State | AR
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Zip | 71943-0907
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Country | US
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Telephone | 870-356-9499
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 907
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City | GLENWOOD
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State | AR
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Zip | 71943-0907
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Country | US
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Telephone | 870-356-9499
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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 | R65190
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License Number State | AR
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