Provider Demographics
NPI:1871835298
Name:HILL, SAMANTHA B (BCBA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:B
Last Name:HILL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 FAIRFAX PIKE
Mailing Address - Street 2:SUITE 15
Mailing Address - City:WHITE POST
Mailing Address - State:VA
Mailing Address - Zip Code:22663-1839
Mailing Address - Country:US
Mailing Address - Phone:540-868-0173
Mailing Address - Fax:
Practice Address - Street 1:1114 FAIRFAX PIKE
Practice Address - Street 2:SUITE 15
Practice Address - City:WHITE POST
Practice Address - State:VA
Practice Address - Zip Code:22663-1839
Practice Address - Country:US
Practice Address - Phone:540-868-0173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-24
Last Update Date:2013-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000159103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-12-10422OtherBCBA