Provider Demographics
NPI:1235880139
Name:HILL, LATONYA (MSE)
Entity Type:Individual
Prefix:MRS
First Name:LATONYA
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:MSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104-5600
Mailing Address - Country:US
Mailing Address - Phone:501-337-7622
Mailing Address - Fax:501-332-2429
Practice Address - Street 1:1625 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-5600
Practice Address - Country:US
Practice Address - Phone:501-337-7622
Practice Address - Fax:501-332-2429
Is Sole Proprietor?:No
Enumeration Date:2022-01-12
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician