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General NPI Number Information
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NPI Number | 1912575192
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Entity Type | Individual
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Provider Name | CARLY J HILL LSW
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Gender | Female
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 06/15/2021
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Provider Practice Location Address
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Address Line | 3300 HENRY AVE # 302
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City | PHILADELPHIA
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State | PA
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Zip | 19129-1141
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Country | US
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Telephone | 215-924-0684
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Fax |
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Provider Business Mailing Address
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Address Line | 128 CONESTOGA RD WAYNE PA ABT B
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City | 19087
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State | PA
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Zip | 19087
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Country | US
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Telephone | 609-815-6384
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW138102
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License Number State | PA
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