Healthcare Provider Details
I. General information
NPI: 1124246640
Provider Name (Legal Business Name): MARY K. HILL PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/22/2007
Last Update Date: 11/30/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 E CAMPUS VIEW BLVD SUITE 220
COLUMBUS OH
43235-5691
US
IV. Provider business mailing address
1 E CAMPUS VIEW BLVD SUITE 220
COLUMBUS OH
43235-5691
US
V. Phone/Fax
- Phone: 614-847-9008
- Fax:
- Phone: 614-847-9008
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | 5490 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TH0100X |
| Taxonomy | Health Service Psychologist |
| License Number | 5490 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TR0400X |
| Taxonomy | Rehabilitation Psychologist |
| License Number | 5490 |
| License Number State | OH |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | 5490 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: