Healthcare Provider Details

I. General information

NPI: 1639081375
Provider Name (Legal Business Name): ANGELA LAURENE HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 S OLD 3C RD
SUNBURY OH
43074-9507
US

IV. Provider business mailing address

7207 NORTHGATE WAY
WESTERVILLE OH
43082-9552
US

V. Phone/Fax

Practice location:
  • Phone: 740-965-3006
  • Fax: 740-965-6471
Mailing address:
  • Phone: 614-445-3750
  • Fax: 614-445-3767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLSP.00791
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: