Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 103741 | TX |
NPI | 1003587569 |
---|---|
Provider Name | Candace Hill |
First Address | Killeen, TX 76549-6243 |
Second Address | Waco, TX 76711-1329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2021 |
Last Update Date | 24/09/2021 |