Healthcare Provider Details

I. General information

NPI: 1760313175
Provider Name (Legal Business Name): ELIZABETH BEEBE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5421 BROOKLYN BLVD
BROOKLYN CENTER MN
55429-3359
US

IV. Provider business mailing address

11424 53RD ST NE
ALBERTVILLE MN
55301-3994
US

V. Phone/Fax

Practice location:
  • Phone: 763-504-7873
  • Fax:
Mailing address:
  • Phone: 651-592-2466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number430657
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: