Doctor Name: | SUSAN MARIE HOISINGTON |
NPI Number: | 1104974674 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | LP0881 |
Business Practice Address: | 15245 Pleasant Valley Rd Center City, MN - 550129640 |
Business Phone Number: | 6512134197 |
Business Fax Number: | 6512134411 |
Mailing Address: | 15245 Pleasant Valley Rd, CENTER CITY |
State: | MN |
Postal Code: | 550129640 |
Phone Number: | 6512134197 |
Fax Number: | 6512134411 |
NPI Enumeration Date: | 01/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TA0400X |
License Number: | LP0881 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |