Provider Demographics
NPI:1912549353
Name:DILL, MONICA SHERISE
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:SHERISE
Last Name:DILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHERISE
Other - Middle Name:
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:566 FOREST HILLS DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31535-2420
Mailing Address - Country:US
Mailing Address - Phone:912-501-6963
Mailing Address - Fax:912-287-6689
Practice Address - Street 1:566 FOREST HILLS DR
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31535-2420
Practice Address - Country:US
Practice Address - Phone:912-501-6963
Practice Address - Fax:912-287-6689
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-16
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator