Healthcare Provider Details

I. General information

NPI: 1679982607
Provider Name (Legal Business Name): KATHERINE L HILLGREN M.A., L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2014
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JEFFERSON BARRACKS DR
SAINT LOUIS MO
63125-4181
US

IV. Provider business mailing address

1212 W LOMBARD ST
SPRINGFIELD MO
65806-2720
US

V. Phone/Fax

Practice location:
  • Phone: 314-750-8408
  • Fax:
Mailing address:
  • Phone: 417-865-1646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3185204
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2012007126
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: