Provider Demographics
NPI:1700410800
Name:HILL, ENZA MARCINE (LSW)
Entity Type:Individual
Prefix:
First Name:ENZA
Middle Name:MARCINE
Last Name: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 1:921 S EDWIN C MOSES BLVD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-3464
Mailing Address - Country:US
Mailing Address - Phone:937-461-1376
Mailing Address - Fax:937-461-9280
Practice Address - Street 1:921 S EDWIN C MOSES BLVD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3464
Practice Address - Country:US
Practice Address - Phone:937-461-1376
Practice Address - Fax:937-461-9280
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.00291971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical