Doctor Name: | MICHAEL ANTHONY SCHWIETERS |
NPI Number: | 1578674685 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSED LP |
License Number: | 0993 |
Business Practice Address: | 2497 7th Ave E Suite 101 North St Paul, MN - 551092496 |
Business Phone Number: | 6517696400 |
Business Fax Number: | 6517696449 |
Mailing Address: | 2497 7th Ave E, Suite 101 NORTH ST PAUL |
State: | MN |
Postal Code: | 551092496 |
Phone Number: | 6517696437 |
Fax Number: | 6517696426 |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 0993 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |