Provider Demographics
NPI:1568545002
Name:RILL, BARBARA JEAN (MA)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JEAN
Last Name:RILL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7080 N AVENIDA ADELLA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2482
Mailing Address - Country:US
Mailing Address - Phone:520-904-2804
Mailing Address - Fax:520-742-6979
Practice Address - Street 1:6812 N ORACLE RD
Practice Address - Street 2:SUITE 114
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4246
Practice Address - Country:US
Practice Address - Phone:520-904-2804
Practice Address - Fax:520-742-6979
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC2221101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLPC2221OtherSTATE LICENSE