Provider Demographics
NPI:1659878486
Name:HILL, MORIAH (QMHS)
Entity Type:Individual
Prefix:
First Name:MORIAH
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:MORIAH
Other - Middle Name:
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:QMHS
Mailing Address - Street 1:293 IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WEST CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-1542
Mailing Address - Country:US
Mailing Address - Phone:937-901-9395
Mailing Address - Fax:
Practice Address - Street 1:1785 BIG HILL RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45439-2219
Practice Address - Country:US
Practice Address - Phone:937-264-0084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-09
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1861798662Medicaid