Provider Demographics
NPI:1770835100
Name:HILL, TASHA DAUN (MA/TLLP)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:DAUN
Last Name:HILL
Suffix:
Gender:F
Credentials:MA/TLLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-3168
Mailing Address - Country:US
Mailing Address - Phone:970-522-4549
Mailing Address - Fax:970-522-6898
Practice Address - Street 1:821 E RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-3365
Practice Address - Country:US
Practice Address - Phone:970-867-4924
Practice Address - Fax:970-867-2695
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
MI6301015101103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6301015101OtherLICENCE #