Individual
MICHAEL K HUNTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LP
Contact information
Practice address
101 W PINE ST, STILLWATER, MN 55082
(651) 439-8800
(651) 439-1040
Mailing address
101 W PINE ST, STILLWATER, MN 55082
(651) 439-8800
(651) 439-1040
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0420
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13K671HU
BCBS
MN
01
—
411333578002
CHAMPUS TRI-CARE
MN
01
—
A3K670HU
BCBS
MN
Enumeration date
08/31/2006
Last updated
07/09/2007
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