Provider Demographics
NPI:1609264761
Name:HILL, MARY L (MA)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:L
Last Name:HILL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 LINDA VISTA DR STE 210
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-3810
Mailing Address - Country:US
Mailing Address - Phone:760-687-9883
Mailing Address - Fax:760-539-9883
Practice Address - Street 1:1650 LINDA VISTA DR STE 210
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-3810
Practice Address - Country:US
Practice Address - Phone:760-687-9883
Practice Address - Fax:760-539-9883
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83383106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist