Provider Demographics
NPI:1346513082
Name:HYLAND, MANDY ERIN (MSW, LGSW)
Entity Type:Individual
Prefix:MRS
First Name:MANDY
Middle Name:ERIN
Last Name:HYLAND
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:137 WEST FILLMORE STREET
Mailing Address - City:PRESTON
Mailing Address - State:MN
Mailing Address - Zip Code:55965-0246
Mailing Address - Country:US
Mailing Address - Phone:507-272-1419
Mailing Address - Fax:507-216-6560
Practice Address - Street 1:101 21ST ST SE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912-4300
Practice Address - Country:US
Practice Address - Phone:507-272-1419
Practice Address - Fax:507-216-6560
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN171351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical