MEDICARE: JOAN 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	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1790100204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN HILL

Provider Business Mailing Address
First Line	:	895 W RHUDES CREEK RD
Second Line	:
City	:	GLENDALE
State	:	KY
Zip	:	42740-8333
Country	:	US
Telephone Number	:	270-737-1050
Fax Number	:	270-737-1892

Provider Business Practice Location Address
First Line	:	895 W RHUDES CREEK RD
Second Line	:
City	:	GLENDALE
State	:	KY
Zip	:	42740-8333
Country	:	US
Telephone Number	:	270-737-1050
Fax Number	:	270-737-1892

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

Provider Enumeration Date	:	02/20/2014
Last Update Date	:	02/20/2014

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Directions to “ JOAN HILL ” Practice Location

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