Provider Demographics
NPI:1184718884
Name:HILL, LAURA L (PH D)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:HILL
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THE CENTER FOR EATING DISORDERS & PSYCHOTHERAPY
Mailing Address - Street 2:445 E GRANVILLE RD BLDG N
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3192
Mailing Address - Country:US
Mailing Address - Phone:614-293-9550
Mailing Address - Fax:614-293-9549
Practice Address - Street 1:THE CENTER FOR EATING DISORDERS & PSYCHOTHERAPY
Practice Address - Street 2:445 E GRANVILLE RD BLDG N
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3192
Practice Address - Country:US
Practice Address - Phone:614-293-9550
Practice Address - Fax:614-293-9549
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4540103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCP23733Medicare ID - Type Unspecified
OHSO8524Medicare UPIN