Provider Demographics
NPI:1235893033
Name:HILLMAN, AMANDA (BS, BCABA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:HILLMAN
Suffix:
Gender:F
Credentials:BS, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 S FULLER DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46241-2233
Mailing Address - Country:US
Mailing Address - Phone:317-670-0866
Mailing Address - Fax:
Practice Address - Street 1:6865 PARKDALE PL
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-5654
Practice Address - Country:US
Practice Address - Phone:317-670-0866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-16-24348106S00000X
IN0-21-13054106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician