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General NPI Number Information
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NPI Number | 1467874495
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Entity Type | Individual
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Provider Name | ANESH PATEL PSYD, LP
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Gender | Male
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 1123 GRAND AVE APT 201
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City | SAINT PAUL
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State | MN
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Zip | 55105-2744
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Country | US
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Telephone | 612-356-1566
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Fax | 612-446-5793
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Provider Business Mailing Address
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Address Line | 3125 37TH AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-2134
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Country | US
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Telephone | 612-356-1566
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Fax | 612-446-5793
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | LP5711
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License Number State | MN
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