Provider Demographics
NPI:1942325626
Name:WILLIAM HOEKSTRA PA
Entity Type:Organization
Organization Name:WILLIAM HOEKSTRA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:HOEKSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:952-212-0300
Mailing Address - Street 1:1020 E 146TH ST
Mailing Address - Street 2:#117
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-6703
Mailing Address - Country:US
Mailing Address - Phone:952-212-0300
Mailing Address - Fax:952-241-4344
Practice Address - Street 1:1020 E 146TH ST
Practice Address - Street 2:#117
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-6703
Practice Address - Country:US
Practice Address - Phone:952-212-0300
Practice Address - Fax:952-241-4344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4257103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN423980600Medicaid