Basic Information
| Provider Information | |||||||||
| NPI: | 1649871401 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILLIER | ||||||||
| FirstName: | SUSANNE | ||||||||
| MiddleName: | JEAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1177 POST RD E | ||||||||
| Address2: | |||||||||
| City: | WESTPORT | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068805436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144996304 | ||||||||
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| Practice Location | |||||||||
| Address1: | 624 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431303903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7406870042 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2020 | ||||||||
| LastUpdateDate: | 11/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | C1100641 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.