Healthcare Provider Details

I. General information

NPI: 1053756247
Provider Name (Legal Business Name): GLADYS BERI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 78TH AVE N
BROOKLYN PARK MN
55445-2758
US

IV. Provider business mailing address

7171 17TH ST N
OAKDALE MN
55128-5405
US

V. Phone/Fax

Practice location:
  • Phone: 844-570-0014
  • Fax:
Mailing address:
  • Phone: 651-757-6441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: