Provider Demographics
NPI:1255760187
Name:HILLENBRAND, PATRICIA (BA, FPA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:HILLENBRAND
Suffix:
Gender:F
Credentials:BA, FPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 HORIZON DRIVE
Mailing Address - Street 2:PEDERSON-KRAG
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743
Mailing Address - Country:US
Mailing Address - Phone:631-223-5028
Mailing Address - Fax:631-920-8165
Practice Address - Street 1:55 HORIZON DRIVE
Practice Address - Street 2:PEDERSON-KRAG
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:631-223-5028
Practice Address - Fax:631-920-8165
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor