Provider Demographics
NPI:1417496613
Name:HILLYER, JESSE MILO (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JESSE
Middle Name:MILO
Last Name:HILLYER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 S 2ND ST STE 300
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3639
Mailing Address - Country:US
Mailing Address - Phone:888-833-2859
Mailing Address - Fax:
Practice Address - Street 1:209 S 2ND ST STE 300
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3639
Practice Address - Country:US
Practice Address - Phone:888-833-2859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3387106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist