Healthcare Provider Details

I. General information

NPI: 1811564933
Provider Name (Legal Business Name): HILLARY ELIZABETH YAKLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4604 N SAGINAW RD
MIDLAND MI
48640-2387
US

IV. Provider business mailing address

4604 N SAGINAW RD
MIDLAND MI
48640-2387
US

V. Phone/Fax

Practice location:
  • Phone: 989-817-2905
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301019398
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: