| Doctor Name: | DR. JEFFRY BRUCE HILLENBERG |
| NPI Number: | 1033158324 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 6301006433 |
| Business Practice Address: | 3577 W 13 Mile Rd Suite 142 Royal Oak, MI - 480736710 |
| Business Phone Number: | 2488924364 |
| Business Fax Number: | 2485518437 |
| Mailing Address: | 32215 Shrewsbury St, FARMINGTON HILLS |
| State: | MI |
| Postal Code: | 483341638 |
| Phone Number: | 2488924364 |
| Fax Number: | 2488553983 |
| NPI Enumeration Date: | 06/05/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 6301006433 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |