Basic Information
| Provider Information | |||||||||
| NPI: | 1164881058 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TEIGLAND | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | MA, LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2713 AUTUMN WOODS DR | ||||||||
| Address2: | |||||||||
| City: | CHASKA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553181160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9522016391 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5125 COUNTY ROAD 101 | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | MINNETONKA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553454156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9529327277 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2016 | ||||||||
| LastUpdateDate: | 05/03/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 2871 | MN | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.