Provider Demographics
NPI:1275795924
Name:HILL-COOPER, SHATIQUA S
Entity Type:Individual
Prefix:MS
First Name:SHATIQUA
Middle Name:S
Last Name:HILL-COOPER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SHATIQUA
Other - Middle Name:S
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 N MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4943
Mailing Address - Country:US
Mailing Address - Phone:803-775-9364
Mailing Address - Fax:803-773-6615
Practice Address - Street 1:215 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:SC
Practice Address - Zip Code:29102-2638
Practice Address - Country:US
Practice Address - Phone:803-435-2124
Practice Address - Fax:803-435-8113
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health