Provider Demographics
NPI:1720367493
Name:DANNER, HILARIE DAWN
Entity Type:Individual
Prefix:MS
First Name:HILARIE
Middle Name:DAWN
Last Name:DANNER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ANGELHEART44OKC
Other - Middle Name:
Other - Last Name:ANGELHEART44OKC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1212 NW 44TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-5223
Mailing Address - Country:US
Mailing Address - Phone:405-686-0299
Mailing Address - Fax:
Practice Address - Street 1:2434 SW 44 ST.
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73119
Practice Address - Country:US
Practice Address - Phone:405-686-0299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health