Provider Demographics
NPI:1184729824
Name:WASSON, HILLARY JANE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:HILLARY
Middle Name:JANE
Last Name:WASSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E WAR MEMORIAL DR STE 201A
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-7570
Mailing Address - Country:US
Mailing Address - Phone:309-431-2012
Mailing Address - Fax:
Practice Address - Street 1:300 E WAR MEMORIAL DR STE 201A
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-7570
Practice Address - Country:US
Practice Address - Phone:309-431-2012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker