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General NPI Number Information
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NPI Number | 1639078991
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Entity Type | Individual
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Provider Name | KRISTINA HOGBERG
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Gender | Female
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Dates
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Enumeration Date | 11/03/2026
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Last Update Date | 11/03/2026
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Provider Practice Location Address
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Address Line | 400 ELI RD
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City | LITTLE CANADA
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State | MN
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Zip | 55117-1108
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Country | US
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Telephone | 651-724-6477
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Fax |
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Provider Business Mailing Address
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Address Line | 499 LONESOME PINE TRL
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City | LINO LAKES
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State | MN
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Zip | 55014-5458
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Country | US
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Telephone | 763-807-1900
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 15892
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License Number State | MN
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