Provider Demographics
NPI:1508293267
Name:TANKERSLEY HILL, AMY JO (LSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:JO
Last Name:TANKERSLEY HILL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MADISON AVE
Mailing Address - Street 2:MORRISTOWN MEDICAL CENTER
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6136
Mailing Address - Country:US
Mailing Address - Phone:973-971-4208
Mailing Address - Fax:973-290-7164
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:MORRISTOWN MEDICAL CENTER
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6136
Practice Address - Country:US
Practice Address - Phone:973-971-4208
Practice Address - Fax:973-290-7164
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05827800101YP2500X
TX21731101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional