| Kim Hiott, Llc | |
|
3617 Braselton Hwy Ste 104 Dacula GA 30019-4667 | |
| (678) 549-2255 | |
| Not Available |
| Full Name | Kim Hiott, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3617 Braselton Hwy Ste 104, Dacula, Georgia |
| Authorized Official Name and Position | Kim Hiott (OWNER) |
| Authorized Official Contact | 6785492255 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Hiott, Llc 260 Grayson Manor Dr Loganville GA 30052-7824 Ph: (678) 549-2255 | Kim Hiott, Llc 3617 Braselton Hwy Ste 104 Dacula GA 30019-4667 Ph: (678) 549-2255 |
| NPI Number | 1366970543 |
|---|---|
| Provider Enumeration Date | 05/31/2017 |
| Last Update Date | 11/13/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366970543 | NPI | - | NPPES |
| 003191800A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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