Provider Demographics
NPI:1912390626
Name:HILL, SHERREL (BCBA)
Entity Type:Individual
Prefix:
First Name:SHERREL
Middle Name:
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 1:80 COLLEGE BLVD E
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-1343
Mailing Address - Country:US
Mailing Address - Phone:850-279-3000
Mailing Address - Fax:850-389-2269
Practice Address - Street 1:315 EDGE AVE
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:FL
Practice Address - Zip Code:32580-1807
Practice Address - Country:US
Practice Address - Phone:850-279-3000
Practice Address - Fax:850-389-2269
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0145910103K00000X
FL1-18-33793103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst