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NPI 1407763691

NPI 1407763691 : ECHO ANNE ALTHOFF : MAPLE GROVE, MN

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General NPI Number Information
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    NPI Number           |    1407763691
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    Entity Type          |    Individual 
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    Provider Name        |    ECHO ANNE ALTHOFF
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/25/2026
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    Last Update Date     |    08/25/2026
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Provider Practice Location Address
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    Address Line         |    12918 63RD AVE N 
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    City                 |    MAPLE GROVE
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    State                |    MN
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    Zip                  |    55369-6001
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    Country              |    US
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    Telephone            |    763-210-9966
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    112 RUSTLE RD 
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    City                 |    JORDAN
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    State                |    MN
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    Zip                  |    55352-1609
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    Country              |    US
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    Telephone            |    320-267-3695
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    4799
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    License Number State |    MN
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