Individual
MR. MICHAEL HITZELBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LP
Contact information
Practice address
425 COON RAPIDS BLVD #200, NSCC, COON RAPIDS, MN 58433
(763) 784-3008
(763) 784-3647
Mailing address
425 COON RAPIDS BLVD #200, NSCC, COON RAPIDS, MN 58433
(763) 784-3008
(763) 784-3647
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3538
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
437709500
—
MN
Enumeration date
11/27/2006
Last updated
01/05/2012
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