Provider Demographics
NPI:1366204844
Name:HILL, TRINA LYNN
Entity type:Individual
Prefix:
First Name:TRINA
Middle Name:LYNN
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:CO
Mailing Address - Zip Code:80615-9112
Mailing Address - Country:US
Mailing Address - Phone:970-454-5200
Mailing Address - Fax:
Practice Address - Street 1:36190 COUNTY ROAD 55
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:CO
Practice Address - Zip Code:80615-9607
Practice Address - Country:US
Practice Address - Phone:970-590-9963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty