Provider Demographics
NPI:1255452991
Name:HILLEREN, BARBARA JOANNE (MA, LP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JOANNE
Last Name:HILLEREN
Suffix:
Gender:F
Credentials:MA, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 TWELVE OAKS CENTER DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-4501
Mailing Address - Country:US
Mailing Address - Phone:952-212-6570
Mailing Address - Fax:952-657-7818
Practice Address - Street 1:600 TWELVE OAKS CENTER DR
Practice Address - Street 2:SUITE 220
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-4501
Practice Address - Country:US
Practice Address - Phone:952-212-6570
Practice Address - Fax:952-657-7818
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MNLP5195103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health