Provider Demographics
NPI:1962843110
Name:HILS, MICHELLE OGILVIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:OGILVIE
Last Name:HILS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 HARBOR CT
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-2489
Mailing Address - Country:US
Mailing Address - Phone:440-930-2899
Mailing Address - Fax:
Practice Address - Street 1:375 HARBOR CT
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-2489
Practice Address - Country:US
Practice Address - Phone:440-930-2899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5259103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical