Basic Information
| Provider Information | |||||||||
| NPI: | 1487856225 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILL | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | RICKY | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MACCCLSP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7136 N COUNTY ROAD 200 E | ||||||||
| Address2: | |||||||||
| City: | OSGOOD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 470378834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8128522295 | ||||||||
| FaxNumber: | 8129346122 | ||||||||
| Practice Location | |||||||||
| Address1: | 321 MITCHELL AVE | ||||||||
| Address2: | |||||||||
| City: | BATESVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 470068909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8129346624 | ||||||||
| FaxNumber: | 8129346122 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 22002022A | IN | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.