Provider Demographics
NPI:1720861479
Name:PHILLIPS, HILARY R
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:R
Last Name:PHILLIPS
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 1:3629 MARTINS DAIRY CIR
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-2451
Mailing Address - Country:US
Mailing Address - Phone:301-254-9650
Mailing Address - Fax:
Practice Address - Street 1:3629 MARTINS DAIRY CIR
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-2451
Practice Address - Country:US
Practice Address - Phone:301-254-9650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD290391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical