Provider Demographics
NPI:1225372683
Name:HILL, LYNETTE (EDD)
Entity type:Individual
Prefix:DR
First Name:LYNETTE
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 E APPALOOSA RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-3203
Mailing Address - Country:US
Mailing Address - Phone:602-463-4422
Mailing Address - Fax:
Practice Address - Street 1:1835 E APPALOOSA RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3203
Practice Address - Country:US
Practice Address - Phone:602-463-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-24
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBEH-000164103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst