MEDICARE: DR. STACIA L. HILL PH.D.

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	103TC1900X	Counseling Psychologist	20041861A	IN

General Provider Information

NPI Number	:	1962681031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STACIA L. HILL PH.D.

Provider Business Mailing Address
First Line	:	11763 KITTERY DR
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46037-7862
Country	:	US
Telephone Number	:	317-915-5066
Fax Number	:

Provider Business Practice Location Address
First Line	:	2511 E 46TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-2460
Country	:	US
Telephone Number	:	317-273-8897
Fax Number	:	317-273-8862

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

Provider Enumeration Date	:	10/25/2007
Last Update Date	:	10/25/2007

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