Provider Demographics
NPI:1255053583
Name:HILLMAN, CHRYSTAL
Entity type:Individual
Prefix:
First Name:CHRYSTAL
Middle Name:
Last Name:HILLMAN
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 1:236 BRIDGEPORT LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-7810
Mailing Address - Country:US
Mailing Address - Phone:678-778-4068
Mailing Address - Fax:
Practice Address - Street 1:236 BRIDGEPORT LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-7810
Practice Address - Country:US
Practice Address - Phone:678-778-4068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical