Provider Demographics
NPI:1679284608
Name:HILTNER, MARIAH LOU (MED, LPCC, GC-C)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:LOU
Last Name:HILTNER
Suffix:
Gender:F
Credentials:MED, LPCC, GC-C
Other - Prefix:
Other - First Name:MARIAH
Other - Middle Name:LOU
Other - Last Name:STEFFENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7895 E RIVER RD APT 209
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-2465
Mailing Address - Country:US
Mailing Address - Phone:701-659-0771
Mailing Address - Fax:
Practice Address - Street 1:10729 TOWN SQUARE DR NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-7923
Practice Address - Country:US
Practice Address - Phone:763-343-9010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3560101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health