Individual
MICHAEL FUKASAWA SCHMITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD, LP
Contact information
Practice address
800 E 28TH ST, WASIE BUILDING, 6TH FLOOR, MR 15600, MINNEAPOLIS, MN 55407-3723
(612) 863-5327
(612) 863-2596
Mailing address
PO BOX 43, MR 10809, MINNEAPOLIS, MN 55440-0043
(612) 262-4813
(612) 262-4194
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP1448
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470315400
—
MN
Enumeration date
03/24/2006
Last updated
11/17/2014
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