Provider Demographics
NPI:1972033462
Name:TRIPP, ELEANOR DONOVAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:ELEANOR
Middle Name:DONOVAN
Last Name:TRIPP
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 VAN BUREN ST NE
Mailing Address - Street 2:STE 200 #27
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-3017
Mailing Address - Country:US
Mailing Address - Phone:715-969-9212
Mailing Address - Fax:
Practice Address - Street 1:1400 VAN BUREN ST NE
Practice Address - Street 2:STE 200 #27
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-3017
Practice Address - Country:US
Practice Address - Phone:715-969-9212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP7022103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical