Provider Demographics
NPI:1407114861
Name:SANDOR, ANNA (MA,LMFT,BCIAC)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:
Last Name:SANDOR
Suffix:
Gender:F
Credentials:MA,LMFT,BCIAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23950 ELDER TURN
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-2938
Mailing Address - Country:US
Mailing Address - Phone:952-401-9187
Mailing Address - Fax:
Practice Address - Street 1:15612 HIGHWAY 7
Practice Address - Street 2:326
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-3543
Practice Address - Country:US
Practice Address - Phone:952-401-9187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2415106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist