Provider Demographics
NPI:1487856225
Name:HILL, ALAN RICKY (MACCCLSP)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:RICKY
Last Name:HILL
Suffix:
Gender:M
Credentials:MACCCLSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7136 N COUNTY ROAD 200 E
Mailing Address - Street 2:
Mailing Address - City:OSGOOD
Mailing Address - State:IN
Mailing Address - Zip Code:47037-8834
Mailing Address - Country:US
Mailing Address - Phone:812-852-2295
Mailing Address - Fax:812-934-6122
Practice Address - Street 1:321 MITCHELL AVE
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-8909
Practice Address - Country:US
Practice Address - Phone:812-934-6624
Practice Address - Fax:812-934-6122
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22002022A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist