Healthcare Provider Details

I. General information

NPI: 1750395240
Provider Name (Legal Business Name): MONICA A BEUMER PHD LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 E SAINT GERMAIN ST
SAINT CLOUD MN
56304-4649
US

IV. Provider business mailing address

617 OAK ST
BRAINERD MN
56401-3610
US

V. Phone/Fax

Practice location:
  • Phone: 320-202-1400
  • Fax:
Mailing address:
  • Phone: 320-202-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2585
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: