Provider Demographics
NPI:1558549097
Name:HILDRETH, LORIE ANN (PHD, CRC, NCC, LMHC)
Entity Type:Individual
Prefix:DR
First Name:LORIE
Middle Name:ANN
Last Name:HILDRETH
Suffix:
Gender:F
Credentials:PHD, CRC, NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6265 SHERIDAN MEADOWS SUITE 122
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-204-5552
Mailing Address - Fax:
Practice Address - Street 1:6265 SHERIDAN MEADOWS SUITE 122
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-204-5552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001401101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health