Healthcare Provider Details

I. General information

NPI: 1164574984
Provider Name (Legal Business Name): MARY DARLENE HILL PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 FULFORD AVE
BEL AIR MD
21014-3851
US

IV. Provider business mailing address

10722 CORDAGE WALK
COLUMBIA MD
21044-3641
US

V. Phone/Fax

Practice location:
  • Phone: 410-893-3082
  • Fax:
Mailing address:
  • Phone: 410-992-9468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3724
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3724
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number3724
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number3724
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: