Provider Demographics
NPI:1679205322
Name:HYLAND, MATTIE HELEN (PSYD)
Entity type:Individual
Prefix:DR
First Name:MATTIE
Middle Name:HELEN
Last Name:HYLAND
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MISS
Other - First Name:MATTIE
Other - Middle Name:HELEN
Other - Last Name:DUNLAP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12608 STATE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-3281
Mailing Address - Country:US
Mailing Address - Phone:901-288-3254
Mailing Address - Fax:
Practice Address - Street 1:12608 STATE RD STE 1
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-3281
Practice Address - Country:US
Practice Address - Phone:901-288-3254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08733103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical