Provider Demographics
NPI:1295573798
Name:EGGERSDORFER, KATHRYN ANNE (MS)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANNE
Last Name:EGGERSDORFER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N BROAD ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3569
Mailing Address - Country:US
Mailing Address - Phone:507-225-1500
Mailing Address - Fax:
Practice Address - Street 1:201 N BROAD ST STE 200
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3569
Practice Address - Country:US
Practice Address - Phone:507-225-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional