Provider Demographics
NPI:1750078572
Name:HILL, LAURA CHRISTINE (LCDC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:CHRISTINE
Last Name:HILL
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:CHRISTINE
Other - Last Name:DIMITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2111 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:TX
Mailing Address - Zip Code:77577-9739
Mailing Address - Country:US
Mailing Address - Phone:830-708-3153
Mailing Address - Fax:
Practice Address - Street 1:3941 HOLCOMB BRIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-2292
Practice Address - Country:US
Practice Address - Phone:830-708-3153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-21
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16046101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)