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General NPI Number Information
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NPI Number | 1558372268
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Entity Type | Organization
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Legal Business Name | ADVANCED BEHAVIORAL MEDICINE AND NEUROPSYCHOLOGY ASSOCIATES, PLLC
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 07/21/2015
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Provider Practice Location Address
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Address Line | 2013 SO 19TH ST
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City | TACOMA
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State | WA
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Zip | 98405
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Country | US
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Telephone | 253-383-3355
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Fax | 253-383-3627
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Provider Business Mailing Address
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Address Line | 2013 SO 19TH ST
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City | TACOMA
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State | WA
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Zip | 98405
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Country | US
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Telephone | 253-383-3355
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Fax | 253-383-3627
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | DR. EDWIN L HILL
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Credential | PHD
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Telephone | 253-383-3355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 601916936
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 601916936
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License Number State | WA
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