Provider Demographics
NPI:1154749760
Name:CATHERINE HILTZ, PH.D., PLLC
Entity type:Organization
Organization Name:CATHERINE HILTZ, PH.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HILTZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-786-8489
Mailing Address - Street 1:2311 E STADIUM BLVD
Mailing Address - Street 2:105 NORTH, STE. 6
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4833
Mailing Address - Country:US
Mailing Address - Phone:734-786-8489
Mailing Address - Fax:
Practice Address - Street 1:2311 E STADIUM BLVD
Practice Address - Street 2:105 NORTH, STE. 6
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4833
Practice Address - Country:US
Practice Address - Phone:734-786-8489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-01
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014868103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3095330Medicaid