Healthcare Provider Details

I. General information

NPI: 1184791972
Provider Name (Legal Business Name): BETH MARIE AUSMAN MS, OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS BETH MARIE LERNER

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 UNIVERSITY AVE SE
MINNEAPOLIS MN
55414-3325
US

IV. Provider business mailing address

6123 W 140TH ST
SAVAGE MN
55378-1937
US

V. Phone/Fax

Practice location:
  • Phone: 612-728-5396
  • Fax: 612-728-5354
Mailing address:
  • Phone: 952-226-5154
  • Fax: 612-728-5354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number103218
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number103218
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: