Provider Demographics
NPI:1699276675
Name:HILL, DIANA NICOLE (COTA)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:NICOLE
Last Name:HILL
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 FREDERICK CIR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:TX
Mailing Address - Zip Code:75762-9017
Mailing Address - Country:US
Mailing Address - Phone:903-520-2312
Mailing Address - Fax:
Practice Address - Street 1:531 FREDERICK CIR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:TX
Practice Address - Zip Code:75762-9017
Practice Address - Country:US
Practice Address - Phone:903-520-2312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX214280224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant