Provider Demographics
NPI:1881790335
Name:HILLIARD, DEAN WESLEY (LMFT)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:WESLEY
Last Name:HILLIARD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:DEAN
Other - Middle Name:WESLEY
Other - Last Name:RITTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1204 HOLLY LANE
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342
Mailing Address - Country:US
Mailing Address - Phone:610-356-2100
Mailing Address - Fax:610-356-6645
Practice Address - Street 1:19 CAMPUS BLVD
Practice Address - Street 2:SUITE 102 DELAWARE COUNTY PROFESSIONAL SERVICES
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073
Practice Address - Country:US
Practice Address - Phone:610-356-2100
Practice Address - Fax:610-356-6645
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000473106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist