Provider Demographics
NPI:1225368327
Name:HILLIARD, ANITA KELLY
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:KELLY
Last Name:HILLIARD
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 1:717 PINE ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-1725
Mailing Address - Country:US
Mailing Address - Phone:513-737-5829
Mailing Address - Fax:
Practice Address - Street 1:1490 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-3305
Practice Address - Country:US
Practice Address - Phone:513-881-7189
Practice Address - Fax:513-881-7188
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor