Healthcare Provider Details

I. General information

NPI: 1427655794
Provider Name (Legal Business Name): SIERRA RACHELLE HILL MS, LLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2020
Last Update Date: 08/09/2022
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 PLYMOUTH RD STE 250
PLYMOUTH MI
48170-1842
US

IV. Provider business mailing address

409 PLYMOUTH RD STE 250
PLYMOUTH MI
48170-1842
US

V. Phone/Fax

Practice location:
  • Phone: 734-416-9098
  • Fax:
Mailing address:
  • Phone: 734-416-9098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6362009206
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6061007732
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: