Provider Demographics
NPI:1265158976
Name:EIGENHEER, ANNALYSSA MARIE
Entity type:Individual
Prefix:
First Name:ANNALYSSA
Middle Name:MARIE
Last Name:EIGENHEER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11157 ZEALAND AVE N
Mailing Address - Street 2:
Mailing Address - City:CHAMPLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55316-3595
Mailing Address - Country:US
Mailing Address - Phone:320-447-5559
Mailing Address - Fax:763-951-3097
Practice Address - Street 1:11157 ZEALAND AVE N
Practice Address - Street 2:
Practice Address - City:CHAMPLIN
Practice Address - State:MN
Practice Address - Zip Code:55316-3595
Practice Address - Country:US
Practice Address - Phone:320-447-5559
Practice Address - Fax:763-951-3097
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty