MEDICARE: AMBER HILL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst	0178372
2	103K00000X	Behavior Analyst	1-22-61758	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0-17-8372	OTHER	BACB
2	0178372	OTHER	BACB
3	1-22-61758	OTHER	BACB

General Provider Information

NPI Number	:	1689227407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER HILL

Provider Business Mailing Address
First Line	:	1051 TIFFANY S
Second Line	:
City	:	POLAND
State	:	OH
Zip	:	44514-1977
Country	:	US
Telephone Number	:	330-646-7469
Fax Number	:

Provider Business Practice Location Address
First Line	:	1051 TIFFANY S
Second Line	:
City	:	POLAND
State	:	OH
Zip	:	44514-1977
Country	:	US
Telephone Number	:	330-646-7469
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2019
Last Update Date	:	09/10/2024

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Directions to “ AMBER HILL ” Practice Location

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