MEDICARE: EMMA LEE HILL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	6451011207	MI

General Provider Information

NPI Number	:	1013640010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA LEE HILL

Provider Business Mailing Address
First Line	:	14485 SENECA RD APT 112
Second Line	:
City	:	VICTORVILLE
State	:	CA
Zip	:	92392-9350
Country	:	US
Telephone Number	:	760-284-2689
Fax Number	:

Provider Business Practice Location Address
First Line	:	628 PINGREE ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-2024
Country	:	US
Telephone Number	:	313-932-5527
Fax Number	:	313-731-1991

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2022
Last Update Date	:	07/06/2022

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Directions to “ EMMA LEE HILL ” Practice Location

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