Basic Information
| Provider Information | |||||||||
| NPI: | 1609531714 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILBRANDS | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | BEA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2704 LITHIA PINECREST RD | ||||||||
| Address2: | |||||||||
| City: | VALRICO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335965623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8136259217 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6152 DELANCEY STATION ST STE 206 | ||||||||
| Address2: | |||||||||
| City: | RIVERVIEW | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335784206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134456122 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2021 | ||||||||
| LastUpdateDate: | 11/03/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | MH19203 | FL | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.