Provider Demographics
NPI:1073133575
Name:HILL, LATOYA SIMONE'
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:SIMONE'
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10115 WILLOW GROVE CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-8571
Mailing Address - Country:US
Mailing Address - Phone:407-575-9405
Mailing Address - Fax:
Practice Address - Street 1:10115 WILLOW GROVE CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-8571
Practice Address - Country:US
Practice Address - Phone:407-575-9405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-24
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18117101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health