Provider Demographics
NPI:1699240572
Name:MANDZIK, HILARY DAWN (PSYD, EDM, HSP-P)
Entity type:Individual
Prefix:DR
First Name:HILARY
Middle Name:DAWN
Last Name:MANDZIK
Suffix:
Gender:F
Credentials:PSYD, EDM, HSP-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 UTLEY BLUFFS DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-4452
Mailing Address - Country:US
Mailing Address - Phone:919-344-1296
Mailing Address - Fax:
Practice Address - Street 1:1135 KILDAIRE FARM RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-7608
Practice Address - Country:US
Practice Address - Phone:919-344-1296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004828103TC0700X, 103TC2200X
NC5351103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent