Provider Demographics
NPI:1194000141
Name:HANDLEY, JILL ANNE (BS)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:ANNE
Last Name:HANDLEY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1472 S HIGHWAY 373
Mailing Address - Street 2:
Mailing Address - City:AMARGOSA VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89020-1514
Mailing Address - Country:US
Mailing Address - Phone:775-372-1199
Mailing Address - Fax:775-372-1196
Practice Address - Street 1:1472 S HIGHWAY 373
Practice Address - Street 2:
Practice Address - City:AMARGOSA VALLEY
Practice Address - State:NV
Practice Address - Zip Code:89020-1514
Practice Address - Country:US
Practice Address - Phone:775-372-1199
Practice Address - Fax:775-372-1196
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst