Provider Demographics
NPI:1114211448
Name:HILDRETH, MARILYN G
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:G
Last Name:HILDRETH
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 1:2626 WINNE AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4917
Mailing Address - Country:US
Mailing Address - Phone:406-443-8838
Mailing Address - Fax:406-443-6367
Practice Address - Street 1:2626 WINNE AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4917
Practice Address - Country:US
Practice Address - Phone:406-443-8838
Practice Address - Fax:406-443-6367
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
237600000X
MTSLP-SU-LIC-12645231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter