Healthcare Provider Details

I. General information

NPI: 1720916828
Provider Name (Legal Business Name): ROBERT J HONERMAN SCHOOL PSYCHOLOGIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 PALMER AVE S
BLOOMINGTON MN
55437-1337
US

IV. Provider business mailing address

8401 PALMER AVE S
BLOOMINGTON MN
55437-1337
US

V. Phone/Fax

Practice location:
  • Phone: 952-681-5454
  • Fax:
Mailing address:
  • Phone: 952-681-5454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number425254
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: