Provider Demographics
NPI:1205075876
Name:HILL-TOVAR, HEATHER LYNN (CDP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNN
Last Name:HILL-TOVAR
Suffix:
Gender:F
Credentials:CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 HAMLET AVE
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-4410
Mailing Address - Country:US
Mailing Address - Phone:401-765-4040
Mailing Address - Fax:401-658-3757
Practice Address - Street 1:80 HAMLET AVE
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-4410
Practice Address - Country:US
Practice Address - Phone:401-765-4040
Practice Address - Fax:401-658-3757
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIGH57134Medicaid