Organization
THE BEACON CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEATHER P LIBBEY PHD (LICENSED PSYCHOLOGIST/DIRECTOR)
(651) 805-1752
Entity
Organization
Contact information
Practice address
790 CLEVELAND AVE S, SUITE 201, SAINT PAUL, MN 55116-3858
(651) 805-1752
Mailing address
790 CLEVELAND AVE S, SUITE 201, SAINT PAUL, MN 55116-3858
(651) 805-1752
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5282
MN
Other
Enumeration date
02/10/2013
Last updated
08/07/2013
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