Basic Information
Provider Information
NPI: 1306406160
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILL
FirstName: EMILY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MS, LPC, NCC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: TRAVIS
OtherFirstName: EMILY
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MS, PLPC, NCC
OtherLastNameType: 1
Mailing Information
Address1: 2905 EVANGELINE ST
Address2:  
City: MONROE
State: LA
PostalCode: 712013723
CountryCode: US
TelephoneNumber: 3186547010
FaxNumber:  
Practice Location
Address1: 2905 EVANGELINE ST
Address2:  
City: MONROE
State: LA
PostalCode: 712013723
CountryCode: US
TelephoneNumber: 3186547010
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/14/2019
LastUpdateDate: 10/16/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/16/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X7314LAY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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