Healthcare Provider Details

I. General information

NPI: 1285445049
Provider Name (Legal Business Name): EMILY ANNE HILLIARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 DAVIS AVE STOP 2
POUGHKEEPSIE NY
12603-2649
US

IV. Provider business mailing address

21 DAVIS AVE STOP 2
POUGHKEEPSIE NY
12603-2649
US

V. Phone/Fax

Practice location:
  • Phone: 845-867-4926
  • Fax:
Mailing address:
  • Phone: 845-867-4926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP138730
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: