Healthcare Provider Details

I. General information

NPI: 1932276052
Provider Name (Legal Business Name): STEPHEN H HILL PH.D., PLLC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 W JEFFERSON ST
BOISE ID
83702-5218
US

IV. Provider business mailing address

1517 W JEFFERSON ST
BOISE ID
83702-5218
US

V. Phone/Fax

Practice location:
  • Phone: 208-385-0888
  • Fax: 208-385-0024
Mailing address:
  • Phone: 208-385-0888
  • Fax: 208-385-0024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY-388
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: