Provider Demographics
NPI:1104140284
Name:MASTERS, HILLARY M (BCBA)
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:M
Last Name:MASTERS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:HILLARY
Other - Middle Name:M
Other - Last Name:MASTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:2185 W 162ND TER
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:KS
Mailing Address - Zip Code:66085-8425
Mailing Address - Country:US
Mailing Address - Phone:720-331-1419
Mailing Address - Fax:
Practice Address - Street 1:2185 W 162ND TER
Practice Address - Street 2:
Practice Address - City:STILWELL
Practice Address - State:KS
Practice Address - Zip Code:66085-8425
Practice Address - Country:US
Practice Address - Phone:720-331-1419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
CO1-08-4710103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201113520AMedicaid
1104140284OtherNPI