Provider Demographics
NPI:1306223383
Name:HILL, SUSAN (MED, LBS)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:MED, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 PHEASANT RUN DR
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-5056
Mailing Address - Country:US
Mailing Address - Phone:215-237-6391
Mailing Address - Fax:
Practice Address - Street 1:318 PHEASANT RUN DRIVE
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-5605
Practice Address - Country:US
Practice Address - Phone:215-237-6391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002714103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst