Provider Demographics
NPI:1437223823
Name:HILL, AMY LOUISE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:LOUISE
Last Name:HILL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:LOUISE
Other - Last Name:HECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15884 W TASHA DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-5724
Mailing Address - Country:US
Mailing Address - Phone:602-373-3136
Mailing Address - Fax:
Practice Address - Street 1:3600 CLIPPER MILL RD.
Practice Address - Street 2:#330
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211
Practice Address - Country:US
Practice Address - Phone:410-369-0000
Practice Address - Fax:866-422-2651
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP0829235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZSLP0829OtherSTATE LICENSE NUMBER
AZ429906Medicaid