Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | ISW9406 | FL |
NPI | 1003207150 |
---|---|
Provider Name | Ms. Latisha M Hill |
First Address | Jacksonville, FL 32277-3851 |
Second Address | Jacksonville, FL 32256-6101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2015 |
Last Update Date | 11/02/2015 |