Basic Information
Provider Information
NPI: 1003001595
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILLYER-WRIGHT
FirstName: NEREIDA
MiddleName: IRENE
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2 TORRANCE CT
Address2:  
City: KENSINGTON
State: MD
PostalCode: 208952844
CountryCode: US
TelephoneNumber: 3019331537
FaxNumber:  
Practice Location
Address1: 2 TORRANCE CT
Address2:  
City: KENSINGTON
State: MD
PostalCode: 208952844
CountryCode: US
TelephoneNumber: 3019331537
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/08/2007
LastUpdateDate: 09/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X1513MDY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

ID Information
IDTypeStateIssuerDescription
151301MDLICENSUREOTHER


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