Provider Demographics
NPI:1326499716
Name:REYES, HILDA (MA)
Entity Type:Individual
Prefix:
First Name:HILDA
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2052 EXCALIBUR DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8318
Mailing Address - Country:US
Mailing Address - Phone:407-270-4849
Mailing Address - Fax:407-381-0697
Practice Address - Street 1:2052 EXCALIBUR DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8318
Practice Address - Country:US
Practice Address - Phone:407-270-4849
Practice Address - Fax:407-381-0697
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.002357101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health