Provider Demographics
NPI:1417501826
Name:HILL, ELIZABETH LEA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LEA
Last Name:HILL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 BLAKEMORE AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-3324
Mailing Address - Country:US
Mailing Address - Phone:404-550-9152
Mailing Address - Fax:
Practice Address - Street 1:1511 NASHVILLE HWY STE A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-2070
Practice Address - Country:US
Practice Address - Phone:931-490-7770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6819235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist