MEDICARE: TYRONE 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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1699022087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYRONE HILL

Provider Business Mailing Address
First Line	:	PO BOX 71805
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89170-1805
Country	:	US
Telephone Number	:	702-541-4633
Fax Number	:	702-577-0778

Provider Business Practice Location Address
First Line	:	1516 E TROPICANA AVE
Second Line	:	#137
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6525
Country	:	US
Telephone Number	:	702-900-6293
Fax Number	:	702-430-2659

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

Provider Enumeration Date	:	08/06/2012
Last Update Date	:	08/06/2012

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Directions to “ TYRONE HILL ” Practice Location

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