Provider Demographics
NPI:1013469220
Name:HILL, TONYA MICHELLE
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:MICHELLE
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TONYA
Other - Middle Name:MICHELLE
Other - Last Name:HILL-LANE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, PLPC
Mailing Address - Street 1:1279 ROSENWALD RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70807-4173
Mailing Address - Country:US
Mailing Address - Phone:225-252-0599
Mailing Address - Fax:
Practice Address - Street 1:1279 ROSENWALD ROAD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70807
Practice Address - Country:US
Practice Address - Phone:225-252-0599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-04
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA5779101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health