Basic Information
| Provider Information | |||||||||
| NPI: | 1245644582 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ECKARD | ||||||||
| FirstName: | ANSHAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 128 PLEASANT ST SE | ||||||||
| Address2: | APPLEBY HALL | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554550434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126247374 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 128 PLEASANT ST SE | ||||||||
| Address2: | APPLEBY HALL | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554550434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126247374 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2014 | ||||||||
| LastUpdateDate: | 06/14/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC1900X | LP 5518 | MN | Y | Behavioral Health & Social Service Providers | Psychologist | Counseling |
No ID Information.