Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PSY000963 | GA |
N | 103TC0700X | Clinical Psychologist | PSY000963 | GA |
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 102L00000X | Psychologist | PSY000963 | GA |
N | 103T00000X | Psychologist | PSY000963 | GA |
N | 103TA0700X | Adult Development & Aging Psychologist | PSY000963 | GA |
N | 103G00000X | Clinical Psychologist | PSY000963 | GA |
N | 103TC0700X | Clinical Psychologist | PSY000963 | GA |
N | 103TH0100X | Health Service |
NPI | 1285787275 |
---|---|
Provider Name | Dr. Connie Dessonville Hill |
First Address | Marietta, GA 30060-8638 |
Second Address | Marietta, GA 30060-8638 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R74734 | (02) | GA |