Provider Demographics
NPI:1881673937
Name:BUCHANAN, ANNE EILEEN (MS, LP)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:EILEEN
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:MS, LP
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:EILEEN
Other - Last Name:BUCHANAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LP
Mailing Address - Street 1:1420 E MINNEHAHA PKWY
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-1146
Mailing Address - Country:US
Mailing Address - Phone:612-825-1695
Mailing Address - Fax:
Practice Address - Street 1:1420 E MINNEHAHA PKWY
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-1146
Practice Address - Country:US
Practice Address - Phone:612-825-1695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1741103T00000X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool