MEDICARE: KIMBERLY REGINA HILL LPC

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	101YP2500X	Professional Counselor	LPC005316	GA

General Provider Information

NPI Number	:	1093959124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY REGINA HILL LPC

Provider Business Mailing Address
First Line	:	PO BOX 78292
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30357-2292
Country	:	US
Telephone Number	:	404-914-2788
Fax Number	:	404-393-9780

Provider Business Practice Location Address
First Line	:	920 DANNON VW SW STE 3204
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-2161
Country	:	US
Telephone Number	:	404-914-2788
Fax Number	:	404-393-9780

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

Provider Enumeration Date	:	04/20/2009
Last Update Date	:	04/20/2009

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Directions to “ KIMBERLY REGINA HILL LPC” Practice Location

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