Provider Demographics
NPI:1164847919
Name:HILL, BRIAN (MA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8581 WYATT RD
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-2019
Mailing Address - Country:US
Mailing Address - Phone:440-546-1512
Mailing Address - Fax:
Practice Address - Street 1:8581 WYATT RD
Practice Address - Street 2:
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-2019
Practice Address - Country:US
Practice Address - Phone:440-546-1512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool