Provider Demographics
NPI:1336237114
Name:ANSARI, ZEHRA (MA,LP)
Entity Type:Individual
Prefix:
First Name:ZEHRA
Middle Name:
Last Name:ANSARI
Suffix:
Gender:F
Credentials:MA,LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2383 STANDRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1545
Mailing Address - Country:US
Mailing Address - Phone:651-770-3353
Mailing Address - Fax:651-704-0676
Practice Address - Street 1:2383 STANDRIDGE AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1545
Practice Address - Country:US
Practice Address - Phone:651-770-3353
Practice Address - Fax:651-704-0676
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1389103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN57330ANOtherBCBS OF MN
MN30128-02OtherPREFERREDONE/BHP
MN6257994OtherMEDICA/UBH
MN104189OtherUCARE MN
MNHP21888OtherHEALTHPARTNERS