Provider Demographics
NPI:1275251340
Name:HILL, TYONDA (TCM)
Entity Type:Individual
Prefix:MISS
First Name:TYONDA
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:TCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 STANDARD VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40210-1600
Mailing Address - Country:US
Mailing Address - Phone:502-302-2161
Mailing Address - Fax:
Practice Address - Street 1:2133 W MARKET ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40212-1532
Practice Address - Country:US
Practice Address - Phone:502-384-5807
Practice Address - Fax:502-901-9070
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty