Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-14-17717 | IN |
NPI | 1003205543 |
---|---|
Provider Name | Jamie Lyn Hill |
First Address | Indianapolis, IN 46268-6135 |
Second Address | Indianapolis, IN 46219-2254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2015 |
Last Update Date | 11/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1-14-17717 | BCBA CERTIFICATION (01) |