Provider Demographics
NPI:1245493238
Name:HILDT, DAVID M (MFTI)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:M
Last Name:HILDT
Suffix:
Gender:M
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 S 200 E STE 308
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-3853
Mailing Address - Country:US
Mailing Address - Phone:801-355-2846
Mailing Address - Fax:801-359-3244
Practice Address - Street 1:660 S 200 E STE 308
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-3853
Practice Address - Country:US
Practice Address - Phone:801-355-2846
Practice Address - Fax:801-359-3244
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5838711-3904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist