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General NPI Number Information
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NPI Number | 1487856225
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Entity Type | Individual
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Provider Name | ALAN RICKY HILL MACCCLSP
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Gender | Male
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 321 MITCHELL AVE
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City | BATESVILLE
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State | IN
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Zip | 47006-8909
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Country | US
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Telephone | 812-934-6624
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Fax | 812-934-6122
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Provider Business Mailing Address
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Address Line | 7136 N COUNTY ROAD 200 E
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City | OSGOOD
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State | IN
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Zip | 47037-8834
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Country | US
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Telephone | 812-852-2295
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Fax | 812-934-6122
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 22002022A
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License Number State | IN
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