Provider Demographics
NPI:1043254675
Name:ANDERSON, FIONA SIAN (PHD, L P)
Entity Type:Individual
Prefix:DR
First Name:FIONA
Middle Name:SIAN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHD, L P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 EDEN AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55436-2333
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5100 EDEN AVE STE 109
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55436-2333
Practice Address - Country:US
Practice Address - Phone:612-419-9832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 4228103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1025767OtherPREFERRED ONE
MN1161843OtherARAZ
SD7777470Medicaid
WI39133300Medicaid
MN266967600Medicaid
MT0491878Medicaid
ND10387Medicaid
MN151280OtherUCARE
MN024A7ANOtherBCBS
MNHP34568OtherHEALTHPARTNERS