| Doctor Name: | MICHAEL R HAMBERG |
| NPI Number: | 1639321094 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | 4955 |
| Business Practice Address: | 1 Mendota Rd W West St Paul, MN - 551184764 |
| Business Phone Number: | 6515546310 |
| Business Fax Number: | 6515546043 |
| Mailing Address: | 1 Mendota Rd W, WEST ST PAUL |
| State: | MN |
| Postal Code: | 551184764 |
| Phone Number: | 6515546310 |
| Fax Number: | 6515546043 |
| NPI Enumeration Date: | 10/16/2008 |
| NPI Last Update Date: | 10/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 4955 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |