Provider Demographics
NPI:1275417941
Name:EBERHARDT, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:EBERHARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10273 YELLOW CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-9144
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:952-401-9805
Practice Address - Street 1:830 SHENANDOAH DR
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-5016
Practice Address - Country:US
Practice Address - Phone:952-800-9510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician