Basic Information
| Provider Information | |||||||||
| NPI: | 1407362312 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROUTT | ||||||||
| FirstName: | HILLARY | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 530 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458041500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192221168 | ||||||||
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| Practice Location | |||||||||
| Address1: | 775 E ELIZA ST | ||||||||
| Address2: | |||||||||
| City: | KENTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 433261486 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4196791219 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2017 | ||||||||
| LastUpdateDate: | 01/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | S.1701383 | OH | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.