Healthcare Provider Details

I. General information

NPI: 1487765590
Provider Name (Legal Business Name): PAUL STEVEN HILL PHD LP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 S MARSCHALL RD STE 250 BHSI LLC
SHAKOPEE MN
55379-2666
US

IV. Provider business mailing address

2497 7TH AVE E STE 101 BHSI LLC
NORTH ST PAUL MN
55109-2496
US

V. Phone/Fax

Practice location:
  • Phone: 651-769-6500
  • Fax: 651-769-6549
Mailing address:
  • Phone: 651-769-6437
  • Fax: 651-769-6426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3784
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: