MEDICARE: HEATHER HILL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1326606799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER HILL

Provider Business Mailing Address
First Line	:	1910 E APPLE AVE STE F
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49442-4281
Country	:	US
Telephone Number	:	231-354-2588
Fax Number	:

Provider Business Practice Location Address
First Line	:	1910 E APPLE AVE STE F
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49442-4281
Country	:	US
Telephone Number	:	231-354-2588
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2019
Last Update Date	:	09/07/2022

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Directions to “ HEATHER HILL ” Practice Location

Language	Start Address	Practice Location

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