Provider Demographics
NPI:1093938755
Name:ORCHARD, ANN LORRAINE (PSYD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:LORRAINE
Last Name:ORCHARD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 PARNELL AVE
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-1515
Mailing Address - Country:US
Mailing Address - Phone:952-848-2297
Mailing Address - Fax:
Practice Address - Street 1:7101 YORK AVE S
Practice Address - Street 2:SUITE 305
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2292
Practice Address - Country:US
Practice Address - Phone:952-848-2297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4178103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN203T4OROtherBCBS