Provider Demographics
NPI:1942657903
Name:HILLS, BRENDA D (BS)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:D
Last Name:HILLS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8880 GREENWOOD RD
Mailing Address - Street 2:APT 37
Mailing Address - City:GREENWOOD
Mailing Address - State:LA
Mailing Address - Zip Code:71033-3123
Mailing Address - Country:US
Mailing Address - Phone:318-773-1271
Mailing Address - Fax:318-947-8157
Practice Address - Street 1:1824 BENTON RD
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-3517
Practice Address - Country:US
Practice Address - Phone:318-947-8157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA712056891101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral