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General NPI Number Information
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NPI Number | 1740607134
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Entity Type | Individual
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Provider Name | ANGELA ST. HILLAIRE PHD, LP, LPC
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Gender | Female
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Dates
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Enumeration Date | 03/24/2014
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 8695 MEADOW LN
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City | BERRIEN SPRINGS
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State | MI
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Zip | 49103-1426
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Country | US
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Telephone | 269-240-8915
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Fax |
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Provider Business Mailing Address
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Address Line | 8695 MEADOW LN
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City | BERRIEN SPRINGS
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State | MI
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Zip | 49103-1426
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Country | US
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Telephone | 269-240-8915
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401014020
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301019245
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License Number State | MI
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