Provider Demographics
NPI:1316062250
Name:HILDEBRANDT, TERESA M (MSN, LMHC)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:M
Last Name:HILDEBRANDT
Suffix:
Gender:F
Credentials:MSN, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7363 85TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-5723
Mailing Address - Country:US
Mailing Address - Phone:206-369-4788
Mailing Address - Fax:206-232-2779
Practice Address - Street 1:7363 85TH AVE SE
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-5723
Practice Address - Country:US
Practice Address - Phone:206-369-4788
Practice Address - Fax:206-232-2779
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005581101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health