Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003324559 |
---|---|
Provider Name | Miles Hill |
First Address | Lexington, KY 40502-1612 |
Second Address | Lexington, KY 40505-9010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2018 |
Last Update Date | 18/01/2018 |