Provider Demographics
NPI:1821694829
Name:HILL, PRISCILA (RBT)
Entity Type:Individual
Prefix:
First Name:PRISCILA
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:PRISCILA
Other - Middle Name:
Other - Last Name:BASTOS DE OLIVEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:7301A W PALMETTO PARK RD STE 100C
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3403
Mailing Address - Country:US
Mailing Address - Phone:954-248-1171
Mailing Address - Fax:
Practice Address - Street 1:7301A W PALMETTO PARK RD STE 100C
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3403
Practice Address - Country:US
Practice Address - Phone:954-248-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-145702106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-20-145702Medicaid