Provider Demographics
NPI:1164589909
Name:HINDMAN, MARY C (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:C
Last Name:HINDMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MOLLY
Other - Middle Name:C
Other - Last Name:HINDMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:4809 TRINITY PL
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-3411
Mailing Address - Country:US
Mailing Address - Phone:215-726-7846
Mailing Address - Fax:215-726-5039
Practice Address - Street 1:4809 TRINITY PL
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-3411
Practice Address - Country:US
Practice Address - Phone:215-726-7846
Practice Address - Fax:215-726-5039
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-006126-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0004640630OtherAETNA PIN
PA0237599000OtherIBC PERSONAL CHOICE