Provider Demographics
NPI:1689686750
Name:HOPPE, C. SARA (MA LP)
Entity Type:Individual
Prefix:
First Name:C.
Middle Name:SARA
Last Name:HOPPE
Suffix:
Gender:F
Credentials:MA LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 MAIN ST SE
Mailing Address - Street 2:#400
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-2124
Mailing Address - Country:US
Mailing Address - Phone:612-379-2640
Mailing Address - Fax:612-379-2820
Practice Address - Street 1:219 MAIN ST SE
Practice Address - Street 2:#400
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-2124
Practice Address - Country:US
Practice Address - Phone:612-379-2640
Practice Address - Fax:612-379-2820
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2676103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist