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NPI Code Detail

MEDICARE: LIYAH HILLEY

MEDICARE: LIYAH HILLEY
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1831962794
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIYAH HILLEY
Provider Business Mailing Address
First Line : 7121 E MOUNT VERNON ST
Second Line :
City : GLEN SAINT MARY
State : FL
Zip : 32040-5085
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7121 E MOUNT VERNON ST
Second Line :
City : GLEN SAINT MARY
State : FL
Zip : 32040-5085
Country : US
Telephone Number : 904-305-2069
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2023
Last Update Date : 11/02/2023

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Directions to “ LIYAH HILLEY ” Practice Location

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