Provider Demographics
NPI:1912083387
Name:AASGAARD, ANNE (MA)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:
Last Name:AASGAARD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:AASGAARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:20 GROVE STREET
Mailing Address - Street 2:WELL AND BEYOND
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458
Mailing Address - Country:US
Mailing Address - Phone:603-924-6681
Mailing Address - Fax:
Practice Address - Street 1:20 GROVE STREET
Practice Address - Street 2:WELL AND BEYOND
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458
Practice Address - Country:US
Practice Address - Phone:603-924-6681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHLMFT 60106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30422227Medicaid