Provider Demographics
NPI:1598502536
Name:MARIETTA HOOGS, PHD, PLLC
Entity type:Organization
Organization Name:MARIETTA HOOGS, PHD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCHOLOGIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOGS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:952-210-0319
Mailing Address - Street 1:202 N CEDAR AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-2306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7300 147TH ST W STE 203
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7580
Practice Address - Country:US
Practice Address - Phone:952-210-0319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist