Provider Demographics
NPI:1982925343
Name:MAYRHOFER, HILLARY A (BCBA)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:A
Last Name:MAYRHOFER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:HILLARY
Other - Middle Name:A
Other - Last Name:LANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:408 ARBOR GLEN CT
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76140-5550
Mailing Address - Country:US
Mailing Address - Phone:682-234-8011
Mailing Address - Fax:
Practice Address - Street 1:408 ARBOR GLEN CT
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76140-5550
Practice Address - Country:US
Practice Address - Phone:682-234-8011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-08-4012103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst