| Doctor Name: | DR. HARRY MARK HOBERMAN |
| NPI Number: | 1366658759 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | LP 1787 |
| Business Practice Address: | 641 Lake St E Suite 222 Wayzata, MN - 553916400 |
| Business Phone Number: | 9524765466 |
| Business Fax Number: | 9529369340 |
| Mailing Address: | 641 Lake St E, Suite 222 WAYZATA |
| State: | MN |
| Postal Code: | 553916400 |
| Phone Number: | 9524765466 |
| Fax Number: | 9529369340 |
| NPI Enumeration Date: | 05/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | LP 1787 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |