Healthcare Provider Details

I. General information

NPI: 1326636655
Provider Name (Legal Business Name): HANNA JEAN FROSETH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNA FROSETH MPS, LPCC, LADC

II. Dates (important events)

Enumeration Date: 01/03/2021
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 SLATER RD STE 145
EAGAN MN
55122-4047
US

IV. Provider business mailing address

4660 SLATER RD STE 145
EAGAN MN
55122-4047
US

V. Phone/Fax

Practice location:
  • Phone: 651-440-9159
  • Fax:
Mailing address:
  • Phone: 651-440-9159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5563
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: