Provider Demographics
NPI:1003611393
Name:HILL, TIFFANY (RBT)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:HILL
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3085 PHEASANT RUN DR APT 735
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47909-3375
Mailing Address - Country:US
Mailing Address - Phone:312-900-2038
Mailing Address - Fax:
Practice Address - Street 1:3085 PHEASANT RUN DR APT 735
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47909-3375
Practice Address - Country:US
Practice Address - Phone:312-900-2038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-23-263427106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician