Ristau, Anastasia Sullwold

Ristau, Anastasia Sullwold is an individual health care provider with primary practice located at 111 Hundertmark Rd Ste 205N , Chaska MN 55318-1586. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Ristau, Anastasia Sullwold can be contacted via phone (952) 903-1350.

Contact Information

Primary practice address
111 Hundertmark Rd Ste 205N Chaska MN 55318-1586
Phone: (952) 903-1350
Fax: (952) 426-3856
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP4538 Minnesota

Profile Details

NPI number 1124049903
LBN Legal business name Ristau, Anastasia Sullwold
Credentials PHD LP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2006
Last updated Nov 10th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124049903 NPPES
Minnesota MEDICAID 949674200

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