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Individual

DR. MARIETTA MUME HOOGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, LP, ABPP

Contact information

Practice address
501 E NICOLLET BLVD STE 100, BURNSVILLE, MN 55337-6772
(952) 435-8516
(763) 302-4336
Mailing address
501 E NICOLLET BLVD STE 100, BURNSVILLE, MN 55337-6772
(952) 435-8516

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
LP5639
MN
103T00000X
Psychologist
071008806
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1497019475
MN
Enumeration date
06/25/2012
Last updated
05/18/2022
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