Provider Demographics
NPI:1134426976
Name:ACHTERHOFF, NANCY (LMFT)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:ACHTERHOFF
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:MAE
Other - Last Name:DEMASTER ACHTERHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:510 LONG ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-4397
Mailing Address - Country:US
Mailing Address - Phone:507-625-4884
Mailing Address - Fax:507-625-6311
Practice Address - Street 1:510 LONG ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-4397
Practice Address - Country:US
Practice Address - Phone:507-625-4884
Practice Address - Fax:507-625-6311
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2268106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist