Provider Demographics
NPI:1639446461
Name:DEAN-HILDRETH, BEULAH SONIA (BS)
Entity Type:Individual
Prefix:MRS
First Name:BEULAH
Middle Name:SONIA
Last Name:DEAN-HILDRETH
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1543 E LARNED ST
Mailing Address - Street 2:APT 1
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-3037
Mailing Address - Country:US
Mailing Address - Phone:313-938-2438
Mailing Address - Fax:
Practice Address - Street 1:1543 E LARNED ST
Practice Address - Street 2:APT 1
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-3037
Practice Address - Country:US
Practice Address - Phone:313-938-2438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)