Individual
MS. LISA N HOOGHEEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LADC
Contact information
Practice address
219 ROBIE ST E, SAINT PAUL, MN 55107-2325
(612) 275-6982
Mailing address
219 ROBIE ST E, SAINT PAUL, MN 55107-2325
(612) 275-6982
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302133
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
302133
STATE LICENSE NUMBER
MN
Enumeration date
09/13/2007
Last updated
09/13/2007
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