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General NPI Number Information
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NPI Number | 1437396389
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Entity Type | Individual
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Provider Name | RAE ELIZABETH HOESING PHD, LP
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Gender | Female
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 10/31/2016
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Provider Practice Location Address
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Address Line | 2301 COMO AVE SUITE 203
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City | SAINT PAUL
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State | MN
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Zip | 55108-1718
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Country | US
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Telephone | 612-834-5191
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Fax |
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Provider Business Mailing Address
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Address Line | 100 W 46TH ST SUITE 2E
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City | MINNEAPOLIS
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State | MN
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Zip | 55419
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Country | US
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Telephone | 612-834-5191
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Fax | 612-465-2617
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | LP5004
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License Number State | MN
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