Healthcare Provider Details

I. General information

NPI: 1366558223
Provider Name (Legal Business Name): ANNA KRISTINA HAUXWELL M.A. LPC, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA KRISTINA EIDE

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 PARKWAY CIR STE 300
BROOKLYN CENTER MN
55430-2849
US

IV. Provider business mailing address

6701 PARKWAY CIR STE 300
BROOKLYN CENTER MN
55430-2849
US

V. Phone/Fax

Practice location:
  • Phone: 763-231-9094
  • Fax:
Mailing address:
  • Phone: 763-231-9094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA1111
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401000605
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number95001009A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401009494
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: