Provider Demographics
NPI:1245644582
Name:ECKARD, ANSHAN (PHD)
Entity type:Individual
Prefix:DR
First Name:ANSHAN
Middle Name:
Last Name:ECKARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 PLEASANT ST SE
Mailing Address - Street 2:APPLEBY HALL
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0434
Mailing Address - Country:US
Mailing Address - Phone:612-624-7374
Mailing Address - Fax:
Practice Address - Street 1:128 PLEASANT ST SE
Practice Address - Street 2:APPLEBY HALL
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0434
Practice Address - Country:US
Practice Address - Phone:612-624-7374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-14
Last Update Date:2014-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 5518103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling