Provider Demographics
NPI:1437396389
Name:HOESING, RAE ELIZABETH (PHD, LP)
Entity Type:Individual
Prefix:
First Name:RAE
Middle Name:ELIZABETH
Last Name:HOESING
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W 46TH ST
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419
Mailing Address - Country:US
Mailing Address - Phone:612-834-5191
Mailing Address - Fax:612-465-2617
Practice Address - Street 1:2301 COMO AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-1718
Practice Address - Country:US
Practice Address - Phone:612-834-5191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5004103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical