Provider Demographics
NPI:1952642555
Name:HYLTON, ROSE (LMFT, PA-C)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:HYLTON
Suffix:
Gender:F
Credentials:LMFT, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 PROVIDENCE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2203
Mailing Address - Country:US
Mailing Address - Phone:919-698-1407
Mailing Address - Fax:
Practice Address - Street 1:401 PROVIDENCE RD STE 100
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2203
Practice Address - Country:US
Practice Address - Phone:919-698-1407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1608106H00000X
NC0010-09874363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist