MEDICARE: BETH NELSON LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	2271	MN

General Provider Information

NPI Number	:	1932450830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH NELSON LMFT

Provider Business Mailing Address
First Line	:	310 E 38TH ST
Second Line	:	209
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55409-1300
Country	:	US
Telephone Number	:	612-243-1600
Fax Number	:	612-767-4624

Provider Business Practice Location Address
First Line	:	310 E 38TH ST
Second Line	:	209
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55409-1300
Country	:	US
Telephone Number	:	612-243-1600
Fax Number	:	612-767-4624

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2012
Last Update Date	:	10/02/2012

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Directions to “ BETH NELSON LMFT” Practice Location

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