Provider Demographics
NPI:1295011724
Name:HILGART, AMBER LEIGH (PSYD, LP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LEIGH
Last Name:HILGART
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:LEIGH
Other - Last Name:HILGART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, LP
Mailing Address - Street 1:200 4TH AVE W
Mailing Address - Street 2:GOVERNMENT CENTER 300
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-1220
Mailing Address - Country:US
Mailing Address - Phone:952-496-8590
Mailing Address - Fax:
Practice Address - Street 1:200 4TH AVE W
Practice Address - Street 2:GOVERNMENT CENTER 300
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-1220
Practice Address - Country:US
Practice Address - Phone:952-496-8590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5392103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical