Individual
MS. ILYSE L HILDEBRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, ACSW
Contact information
Practice address
8626 SOUTH ST., STE. 200, FISHERS, IN 46038
(317) 595-9811
(317) 595-9811
Mailing address
5806 INDIANOLA AVE, INDIANAPOLIS, IN 46220-2775
(317) 466-1621
(317) 595-9811
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004051A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000258150
INSURANCE CARRIER PIN
IN
Enumeration date
02/13/2007
Last updated
07/08/2007
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