Doctor Name: | DR. RAYMOND EARL HILLIS |
NPI Number: | 1013211333 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 2254 |
Business Practice Address: | 1536 Bishops Lodge Rd Santa Fe, NM - 875060005 |
Business Phone Number: | 5054120246 |
Business Fax Number: | |
Mailing Address: | Po Box 217, SAGUACHE |
State: | CO |
Postal Code: | 811490217 |
Phone Number: | 5054120246 |
Fax Number: | |
NPI Enumeration Date: | 12/29/2010 |
NPI Last Update Date: | 12/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 2254 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |