Individual
DR. BERYL LESLIE WINGATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1219 MARQUETTE AVE, SUITE # 80, MINNEAPOLIS, MN 55403-2488
(612) 338-9012
(612) 338-9020
Mailing address
1219 MARQUETTE AVE., SUITE # 80, MINNEAPOLIS, MN 55403-2489
(612) 338-9012
(612) 338-9020
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4332
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
426S4WI
BCBS
MN
01
—
HP36316
HEALTHPARTNERS
MN
Enumeration date
11/03/2006
Last updated
07/08/2007
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