Provider Demographics
NPI:1679262422
Name:HILL, KATHERINE REBECCA (RBT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:REBECCA
Last Name:HILL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4575 BONNEY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3831
Mailing Address - Country:US
Mailing Address - Phone:757-428-3367
Mailing Address - Fax:757-429-1630
Practice Address - Street 1:4575 BONNEY RD STE 101
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3831
Practice Address - Country:US
Practice Address - Phone:757-428-3367
Practice Address - Fax:757-428-1630
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician