Provider Demographics
NPI:1710632658
Name:HILLAKER, GRACE ANNE
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:ANNE
Last Name:HILLAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HARBOR ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-6077
Mailing Address - Country:US
Mailing Address - Phone:781-462-7492
Mailing Address - Fax:
Practice Address - Street 1:11 HARBOR ST APT 2R
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-6077
Practice Address - Country:US
Practice Address - Phone:781-462-7492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health