Provider Demographics
NPI:1174667497
Name:HILL-VILLANUEVA, CARRIE A (AUD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:A
Last Name:HILL-VILLANUEVA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-2124
Mailing Address - Country:US
Mailing Address - Phone:317-736-0080
Mailing Address - Fax:317-736-9301
Practice Address - Street 1:1020 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-2124
Practice Address - Country:US
Practice Address - Phone:317-736-0080
Practice Address - Fax:317-736-9301
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002221A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200733540AOtherFIRST STEPS ADVANCED AUD
IN200182700BMedicaid
IN200182700BMedicaid