Healthcare Provider Details

I. General information

NPI: 1306413794
Provider Name (Legal Business Name): LEAH HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2021
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 CLEAR SKY CT
CLARKSVILLE TN
37043-5951
US

IV. Provider business mailing address

623 WOODHAVEN DR
CLARKSVILLE TN
37042-3910
US

V. Phone/Fax

Practice location:
  • Phone: 586-539-7930
  • Fax:
Mailing address:
  • Phone: 586-539-7930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: