Provider Demographics
NPI:1487210845
Name:HILL, REBECCA DIANE (LAC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:DIANE
Last Name:HILL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 WALLINGWOOD DR STE 7C
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6929
Mailing Address - Country:US
Mailing Address - Phone:512-779-0781
Mailing Address - Fax:
Practice Address - Street 1:2525 WALLINGWOOD DR STE 7C
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6929
Practice Address - Country:US
Practice Address - Phone:512-779-0781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-11
Last Update Date:2019-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01809171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist