Provider Demographics
NPI:1588074538
Name:HILL, JONATHAN BLAKE (MS)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:BLAKE
Last Name:HILL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 MORRIS LN
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-8977
Mailing Address - Country:US
Mailing Address - Phone:870-397-3010
Mailing Address - Fax:
Practice Address - Street 1:145 MORRIS LN
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-8977
Practice Address - Country:US
Practice Address - Phone:870-397-3010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist