Individual
JEFFREY LEROY HILDRETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPA
Contact information
Practice address
401 E WHITAKER MILL RD, RALEIGH, NC 27608-2631
(919) 857-9108
(919) 250-3943
Mailing address
PO BOX 14169, RALEIGH, NC 27620-4169
(919) 857-9108
(919) 250-3943
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0511
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107310
—
NC
Enumeration date
03/13/2007
Last updated
07/08/2007
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