Provider Demographics
NPI:1164075941
Name:HILTON, DEBRA MATHESON (MS LAC)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:MATHESON
Last Name:HILTON
Suffix:
Gender:F
Credentials:MS LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 E NIGHTHAWK WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-7866
Mailing Address - Country:US
Mailing Address - Phone:480-326-7796
Mailing Address - Fax:
Practice Address - Street 1:16815 S DESERT FOOTHILLS PKWY STE 134
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-8465
Practice Address - Country:US
Practice Address - Phone:602-550-5221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-19
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17521101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty