Provider Demographics
NPI:1902304140
Name:HILL, GWENDOLYN ARCENEAUX (RSW)
Entity Type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:ARCENEAUX
Last Name:HILL
Suffix:
Gender:F
Credentials:RSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 VICTORIA LIGHTS LN
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-5341
Mailing Address - Country:US
Mailing Address - Phone:318-278-0088
Mailing Address - Fax:
Practice Address - Street 1:113 W CONVENT ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-6903
Practice Address - Country:US
Practice Address - Phone:337-543-0770
Practice Address - Fax:337-534-4370
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator