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General NPI Number Information
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NPI Number | 1134450505
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Entity Type | Organization
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Legal Business Name | HYLAND PSYCHOLOGICAL SERVICES, INC.
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Dates
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Enumeration Date | 01/24/2010
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Last Update Date | 01/24/2010
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Provider Practice Location Address
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Address Line | 8380 SIX FORKS RD SUITE 104
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City | RALEIGH
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State | NC
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Zip | 27615-5081
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Country | US
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Telephone | 919-844-7725
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Fax |
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Provider Business Mailing Address
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Address Line | 8380 SIX FORKS RD SUITE 104
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City | RALEIGH
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State | NC
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Zip | 27615-5081
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Country | US
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Telephone | 919-844-7725
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KATHLEEN CLAIRE HYLAND
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Credential | PSY.D., L.P.
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Telephone | 919-844-7725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3600
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License Number State | NC
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