Provider Demographics
NPI:1730376690
Name:HILDEBRAND, ASTRID H
Entity type:Individual
Prefix:MISS
First Name:ASTRID
Middle Name:H
Last Name:HILDEBRAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:797 WASHINGTON ST.
Mailing Address - Street 2:STE 4
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02460
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:797 WASHINGTON ST.
Practice Address - Street 2:STE 4
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02460
Practice Address - Country:US
Practice Address - Phone:857-247-2958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1001550OtherNHP
MA1319744Medicaid
MA8411OtherBMC
MA691470OtherTUFTS