Provider Demographics
NPI:1952049892
Name:HILL, AUNDREA LYNN (DOT)
Entity Type:Individual
Prefix:
First Name:AUNDREA
Middle Name:LYNN
Last Name:HILL
Suffix:
Gender:F
Credentials:DOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LEMMON
Mailing Address - State:SD
Mailing Address - Zip Code:57638-1834
Mailing Address - Country:US
Mailing Address - Phone:605-374-5844
Mailing Address - Fax:605-374-9524
Practice Address - Street 1:601 MAIN AVE
Practice Address - Street 2:
Practice Address - City:LEMMON
Practice Address - State:SD
Practice Address - Zip Code:57638-1834
Practice Address - Country:US
Practice Address - Phone:605-374-5844
Practice Address - Fax:605-374-9524
Is Sole Proprietor?:No
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1228225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist